Healthcare Provider Details

I. General information

NPI: 1760740468
Provider Name (Legal Business Name): LESLEIGH FRANKLIN, PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 29TH ST STE 405O
OAKLAND CA
94609-3549
US

IV. Provider business mailing address

400 29TH ST STE 405O
OAKLAND CA
94609-3549
US

V. Phone/Fax

Practice location:
  • Phone: 510-821-3417
  • Fax: 510-842-1501
Mailing address:
  • Phone: 510-821-3417
  • Fax: 510-842-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY17471
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LESLEIGH FRANKLIN
Title or Position: OWNER
Credential: PHD
Phone: 510-268-8544