Provider Demographics
NPI:1184458614
Name:ALVAREZ, LESLIE ANN
Entity type:Individual
Prefix:
First Name:LESLIE ANN
Middle Name:
Last Name:ALVAREZ
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 1:10799 POPLAR ST APT 310
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2261
Mailing Address - Country:US
Mailing Address - Phone:806-470-4491
Mailing Address - Fax:
Practice Address - Street 1:17982 SKY PARK CIR STE J
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6482
Practice Address - Country:US
Practice Address - Phone:949-809-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health