Provider Demographics
NPI:1568657633
Name:BAUMAN, LESLIE ALLISON (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ALLISON
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4825
Mailing Address - Country:US
Mailing Address - Phone:530-302-5638
Mailing Address - Fax:
Practice Address - Street 1:884 LINCOLN WAY
Practice Address - Street 2:SUITE 32B
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4825
Practice Address - Country:US
Practice Address - Phone:530-302-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 50701251S00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No251S00000XAgenciesCommunity/Behavioral Health