Provider Demographics
NPI:1851838254
Name:WESTBROOK, LESLIE (LMFT #127260)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:LMFT #127260
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 BENNINGTON ST
Mailing Address - Street 2:#B
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-6356
Mailing Address - Country:US
Mailing Address - Phone:909-238-0328
Mailing Address - Fax:
Practice Address - Street 1:7365 CARNELIAN ST
Practice Address - Street 2:STE. 104
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1158
Practice Address - Country:US
Practice Address - Phone:909-980-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127260106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist