Provider Demographics
NPI:1770818312
Name:HARRIS, LESLIE
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E 7TH ST
Mailing Address - Street 2:#105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-1436
Mailing Address - Country:US
Mailing Address - Phone:213-537-0110
Mailing Address - Fax:213-537-0880
Practice Address - Street 1:600 E 7TH ST
Practice Address - Street 2:#105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1436
Practice Address - Country:US
Practice Address - Phone:213-537-0110
Practice Address - Fax:213-537-0880
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)