Healthcare Provider Details

I. General information

NPI: 1962447425
Provider Name (Legal Business Name): LESLEY A DEBRIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 CARMELITA DR
SAN CARLOS CA
94070-2956
US

IV. Provider business mailing address

1881 CARMELITA DR
SAN CARLOS CA
94070-2956
US

V. Phone/Fax

Practice location:
  • Phone: 425-449-9577
  • Fax: 425-264-6066
Mailing address:
  • Phone: 425-449-9577
  • Fax: 425-264-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA81328
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60588420
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: