Provider Demographics
NPI:1790142545
Name:DE LA TORRE, LESLIE LORENE
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:LORENE
Last Name:DE LA TORRE
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 1:119 EL DORADO DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5969
Mailing Address - Country:US
Mailing Address - Phone:925-812-0845
Mailing Address - Fax:
Practice Address - Street 1:1481 ROSAL LN UNIT B
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2640
Practice Address - Country:US
Practice Address - Phone:922-812-0845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker