Provider Demographics
NPI:1659392140
Name:WESTFIELD BAXTER, LESLIE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MARIE
Last Name:WESTFIELD BAXTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:MARIE
Other - Last Name:WESTFIELD-METELLUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:15661 HALINOR ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-4423
Mailing Address - Country:US
Mailing Address - Phone:702-373-1265
Mailing Address - Fax:
Practice Address - Street 1:8871 W FLAMINGO RD STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8729
Practice Address - Country:US
Practice Address - Phone:702-373-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV234103T00000X, 103TA0700X, 103T00000X, 103TP2701X, 103TR0400X, 103TA0400X
AZ1727103T00000X
AZ234103TF0200X, 103TF0200X, 103T00000X
NV1727103TF0200X, 103TF0200X
CA34216103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507024Medicaid
AZ72046Medicare ID - Type UnspecifiedGROUP
NV100507024Medicaid