Healthcare Provider Details

I. General information

NPI: 1841447786
Provider Name (Legal Business Name): LESLIE CHARLES BUSH REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 07/26/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10224 HEATHER VALLEY DR
BAKERSFIELD CA
93312-2954
US

IV. Provider business mailing address

10224 HEATHER VALLEY DR
BAKERSFIELD CA
93312-2954
US

V. Phone/Fax

Practice location:
  • Phone: 661-496-3533
  • Fax: 661-587-0427
Mailing address:
  • Phone: 661-496-3533
  • Fax: 661-587-0427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number551612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: