Provider Demographics
NPI:1689904997
Name:ENRIGHT, LESLIE RENEE' (CPT1)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:RENEE'
Last Name:ENRIGHT
Suffix:
Gender:F
Credentials:CPT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 BICKLEIGH LOOP
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 PETERS AVE STE 120
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6594
Practice Address - Country:US
Practice Address - Phone:925-323-3435
Practice Address - Fax:925-462-2583
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35886246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy