Healthcare Provider Details

I. General information

NPI: 1053151860
Provider Name (Legal Business Name): LESLY GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 DOVER PKWY
DELANO CA
93215-3440
US

IV. Provider business mailing address

1540 POPPY CT
WASCO CA
93280-9403
US

V. Phone/Fax

Practice location:
  • Phone: 661-635-3050
  • Fax:
Mailing address:
  • Phone: 661-668-7494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: