Healthcare Provider Details

I. General information

NPI: 1457199184
Provider Name (Legal Business Name): LESLIE SABRINA SMITH CADCII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 MEADOWVIEW RD
SACRAMENTO CA
95832-1498
US

IV. Provider business mailing address

3780 SILVERWOOD RD
WEST SACRAMENTO CA
95691-5472
US

V. Phone/Fax

Practice location:
  • Phone: 916-391-0700
  • Fax:
Mailing address:
  • Phone: 916-271-0678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAII063080521
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: