Provider Demographics
NPI:1770085920
Name:LESNE, ALBAN (CADC-I #CI29780520)
Entity type:Individual
Prefix:MR
First Name:ALBAN
Middle Name:
Last Name:LESNE
Suffix:
Gender:M
Credentials:CADC-I #CI29780520
Other - Prefix:MR
Other - First Name:ALBAN
Other - Middle Name:M
Other - Last Name:LESNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CADC-I
Mailing Address - Street 1:PO BOX 641611
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94164-1611
Mailing Address - Country:US
Mailing Address - Phone:917-698-1550
Mailing Address - Fax:
Practice Address - Street 1:450 STANYAN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1019
Practice Address - Country:US
Practice Address - Phone:415-750-5872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-04
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
CACI29780520390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA390200000XMedicaid
CA390200000XOtherMEDI-CAL