Provider Demographics
NPI:1457434110
Name:LESSENGER, LESLIE H (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:H
Last Name:LESSENGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 GEORGIA ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5946
Mailing Address - Country:US
Mailing Address - Phone:707-644-4098
Mailing Address - Fax:707-751-0857
Practice Address - Street 1:301 GEORGIA ST
Practice Address - Street 2:SUITE 306
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5946
Practice Address - Country:US
Practice Address - Phone:707-644-4098
Practice Address - Fax:707-751-0857
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16169103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical