Healthcare Provider Details

I. General information

NPI: 1588582597
Provider Name (Legal Business Name): LESLIE SEALS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 N GRAPE ST
ESCONDIDO CA
92025-3079
US

IV. Provider business mailing address

31878 FRONTIER MANOR ST
MENIFEE CA
92584-7461
US

V. Phone/Fax

Practice location:
  • Phone: 760-975-9939
  • Fax:
Mailing address:
  • Phone: 951-217-6557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95462275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: