Healthcare Provider Details

I. General information

NPI: 1225932502
Provider Name (Legal Business Name): LESLIE RENEE ASCENCIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W 3RD ST STE 101
LOS ANGELES CA
90057-1944
US

IV. Provider business mailing address

2100 W 3RD ST STE 101
LOS ANGELES CA
90057-1944
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax: 213-353-4973
Mailing address:
  • Phone: 888-499-9303
  • Fax: 213-353-4973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number202631979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: