Provider Demographics
NPI:1790131969
Name:PEARCE, LESLEY WELLS
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:WELLS
Last Name:PEARCE
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 1:12927 SLEEPY WIND ST
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2935
Mailing Address - Country:US
Mailing Address - Phone:310-989-3092
Mailing Address - Fax:805-530-3989
Practice Address - Street 1:1820 MARRON RD STE 102
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1177
Practice Address - Country:US
Practice Address - Phone:760-434-0125
Practice Address - Fax:760-434-4531
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8100237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist