Provider Demographics
NPI:1235249699
Name:ROMAN, LESLIE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:ROMAN
Suffix:
Gender:F
Credentials:PHD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19197 GOLDEN VALLEY ROAD
Mailing Address - Street 2:338
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1428
Mailing Address - Country:US
Mailing Address - Phone:661-250-3323
Mailing Address - Fax:661-250-3323
Practice Address - Street 1:23300 CINEMA DRIVE
Practice Address - Street 2:2908
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-250-3323
Practice Address - Fax:661-250-3323
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 14626103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist