Healthcare Provider Details

I. General information

NPI: 1861031239
Provider Name (Legal Business Name): LESLEY ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date: 09/09/2024
Reactivation Date: 10/21/2024

III. Provider practice location address

1360 E LASSEN AVE
CHICO CA
95973-7823
US

IV. Provider business mailing address

1360 E LASSEN AVE
CHICO CA
95973-7823
US

V. Phone/Fax

Practice location:
  • Phone: 530-267-1700
  • Fax:
Mailing address:
  • Phone: 530-267-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: