Provider Demographics
NPI:1023261393
Name:LOUBIER, LESLIE A (PSYD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:LOUBIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 HONOLULU AVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1800
Mailing Address - Country:US
Mailing Address - Phone:818-249-4300
Mailing Address - Fax:
Practice Address - Street 1:2490 HONOLULU AVE
Practice Address - Street 2:SUITE 135
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1800
Practice Address - Country:US
Practice Address - Phone:818-249-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20006103TC0700X, 103TE1100X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth