Provider Demographics
NPI:1457786170
Name:LESLIE-JONES, TIKESHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:TIKESHA
Middle Name:
Last Name:LESLIE-JONES
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 1:584 PINNACLE DR W
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8924
Mailing Address - Country:US
Mailing Address - Phone:559-456-1870
Mailing Address - Fax:
Practice Address - Street 1:2811 W CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-2307
Practice Address - Country:US
Practice Address - Phone:559-493-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TH0004X
CA25980103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth