Provider Demographics
NPI:1780456996
Name:GARCIA, LESLIE MARIA (BS, SLPA)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:MARIA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BS, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 W MARCH LN STE 117S
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-6500
Mailing Address - Country:US
Mailing Address - Phone:209-952-2588
Mailing Address - Fax:
Practice Address - Street 1:3031 W MARCH LN STE 117S
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-6500
Practice Address - Country:US
Practice Address - Phone:209-952-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA81472355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant