Healthcare Provider Details

I. General information

NPI: 1801556048
Provider Name (Legal Business Name): LESLIE WEINSTEIN AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 N VULCAN AVE
ENCINITAS CA
92024-2190
US

IV. Provider business mailing address

721 N VULCAN AVE
ENCINITAS CA
92024-2190
US

V. Phone/Fax

Practice location:
  • Phone: 619-787-8591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14452
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number141483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: