Provider Demographics
NPI:1518429174
Name:VUONCINO, LESLIE HOPPER (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:HOPPER
Last Name:VUONCINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:HOPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2335 STOCKTON BLVD.
Mailing Address - Street 2:NORTH ADDITION, 5TH FLOOR
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:916-734-8395
Mailing Address - Fax:916-734-5633
Practice Address - Street 1:2315 STOCKTON BLVD # OP512
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA180334390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program