Provider Demographics
NPI:1518109511
Name:HARRIS, LESLIE ANN (MS, MFT)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 HOPYARD RD
Mailing Address - Street 2:SUITE O
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5247
Mailing Address - Country:US
Mailing Address - Phone:925-513-3128
Mailing Address - Fax:
Practice Address - Street 1:3015 HOPYARD RD
Practice Address - Street 2:SUITE O
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5247
Practice Address - Country:US
Practice Address - Phone:925-513-3128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist