Provider Demographics
NPI:1710078910
Name:LESKOVAR, JOANN L (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:L
Last Name:LESKOVAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MARLIN CV
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-2322
Mailing Address - Country:US
Mailing Address - Phone:510-898-1808
Mailing Address - Fax:
Practice Address - Street 1:1700 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3191
Practice Address - Country:US
Practice Address - Phone:510-684-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS3781104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ27698ZMedicare ID - Type Unspecified