Provider Demographics
NPI:1770388613
Name:ALVAREZ, LESLIE A
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
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 1:501 MARIN ST STE 225
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4301
Mailing Address - Country:US
Mailing Address - Phone:805-379-1401
Mailing Address - Fax:
Practice Address - Street 1:501 MARIN ST STE 225
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4301
Practice Address - Country:US
Practice Address - Phone:805-379-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician