Healthcare Provider Details

I. General information

NPI: 1689085490
Provider Name (Legal Business Name): LAUREN JUSTINE LESLIE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN JUSTINE HASLER D.O.

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 ALHAMBRA BLVD STE 230
SACRAMENTO CA
95816-5241
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 916-262-9440
  • Fax: 916-262-9445
Mailing address:
  • Phone: 800-470-0071
  • Fax: 916-854-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number5101020876
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number25000
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number310278
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: