Healthcare Provider Details

I. General information

NPI: 1508788712
Provider Name (Legal Business Name): LESLEY LEIGH HARDEE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WHEATLAND PARK DR
WHEATLAND CA
95692-9286
US

IV. Provider business mailing address

100 WHEATLAND PARK DR
WHEATLAND CA
95692-9286
US

V. Phone/Fax

Practice location:
  • Phone: 530-633-3135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number16008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: