Healthcare Provider Details

I. General information

NPI: 1285431007
Provider Name (Legal Business Name): TENAZCITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15661 HALINOR ST
HESPERIA CA
92345-4423
US

IV. Provider business mailing address

15661 HALINOR ST
HESPERIA CA
92345-4423
US

V. Phone/Fax

Practice location:
  • Phone: 702-373-1265
  • Fax: 442-255-1720
Mailing address:
  • Phone: 702-373-1275
  • Fax: 442-255-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE WESTFIELD BAXTER
Title or Position: DIRECTOR
Credential: PHD
Phone: 702-373-1265