Healthcare Provider Details

I. General information

NPI: 1194879528
Provider Name (Legal Business Name): LESLIE ARIA PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W MACARTHUR
OAKLAND CA
94611-5641
US

IV. Provider business mailing address

275 W MACARTHUR
OAKLAND CA
94611-5641
US

V. Phone/Fax

Practice location:
  • Phone: 916-607-1297
  • Fax:
Mailing address:
  • Phone: 916-607-1297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY 19105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: