Provider Demographics
NPI:1023468360
Name:WOLFF, LESLIE L (RN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:L
Last Name:WOLFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 ROLLINS RD
Mailing Address - Street 2:APT 305
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2576
Mailing Address - Country:US
Mailing Address - Phone:307-287-2534
Mailing Address - Fax:
Practice Address - Street 1:2600 S EL CAMINO REAL
Practice Address - Street 2:STE 200
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2380
Practice Address - Country:US
Practice Address - Phone:650-373-0777
Practice Address - Fax:650-645-1770
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95089516163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse