Healthcare Provider Details
I. General information
NPI: 1568750024
Provider Name (Legal Business Name): LESLIE DYAN FOSTER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 COLUMBUS ST
BAKERSFIELD CA
93305-1936
US
IV. Provider business mailing address
PO BOX 1000
BAKERSFIELD CA
93302-1000
US
V. Phone/Fax
- Phone: 661-868-8300
- Fax: 661-868-8317
- Phone: 661-868-6601
- Fax: 661-868-6666
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 23408 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: