Healthcare Provider Details

I. General information

NPI: 1184134264
Provider Name (Legal Business Name): LESLEE-ANNE SESNO BAUER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2271 ALPINE BLVD STE A
ALPINE CA
91901-1101
US

IV. Provider business mailing address

2271 ALPINE BLVD STE A
ALPINE CA
91901-1101
US

V. Phone/Fax

Practice location:
  • Phone: 888-688-0248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number104821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: