Healthcare Provider Details

I. General information

NPI: 1497650477
Provider Name (Legal Business Name): LESLIE STEPHANIE PALATO-CISNEROS MASTERS INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 E CALEY AVE STE 300
CENTENNIAL CO
80111-6710
US

IV. Provider business mailing address

11335 W 76TH WAY
ARVADA CO
80005-3407
US

V. Phone/Fax

Practice location:
  • Phone: 720-598-5512
  • Fax:
Mailing address:
  • Phone: 303-847-1617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: