Provider Demographics
NPI:1598891715
Name:MASUDA, LESLEY JANE
Entity Type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:JANE
Last Name:MASUDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N SAN MARCOS RD
Mailing Address - Street 2:#A
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-1959
Mailing Address - Country:US
Mailing Address - Phone:806-683-4477
Mailing Address - Fax:
Practice Address - Street 1:133 E HALEY ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2330
Practice Address - Country:US
Practice Address - Phone:805-564-6057
Practice Address - Fax:805-963-8849
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)