Healthcare Provider Details

I. General information

NPI: 1053935130
Provider Name (Legal Business Name): LESLIE JESSICA CONTRERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 E GISH RD
SAN JOSE CA
95112-4706
US

IV. Provider business mailing address

232 E GISH RD
SAN JOSE CA
95112-4706
US

V. Phone/Fax

Practice location:
  • Phone: 408-876-4284
  • Fax:
Mailing address:
  • Phone: 408-876-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: