Provider Demographics
NPI:1396386249
Name:SLATER, LEAH (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44274 GEORGE CUSHMAN CT STE 210
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5945
Mailing Address - Country:US
Mailing Address - Phone:951-302-4302
Mailing Address - Fax:
Practice Address - Street 1:44274 GEORGE CUSHMAN CT STE 210
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5945
Practice Address - Country:US
Practice Address - Phone:951-302-4603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012697363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner