Provider Demographics
NPI:1346414984
Name:LESLIE, JESSICA DENISE (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DENISE
Last Name:LESLIE
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 W AVENUE J
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2942
Mailing Address - Country:US
Mailing Address - Phone:661-940-9094
Mailing Address - Fax:661-951-1030
Practice Address - Street 1:1331 W AVENUE J
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2942
Practice Address - Country:US
Practice Address - Phone:661-940-9094
Practice Address - Fax:661-951-1030
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health