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General NPI Number Information
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NPI Number | 1225517493
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Entity Type | Individual
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Provider Name | LESLYE FLORES
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 2420 MARTIN RD STE 200
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City | FAIRFIELD
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State | CA
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Zip | 94534-8610
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Country | US
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Telephone | 707-439-8765
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 COURAGE DR # MS 10-270
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City | FAIRFIELD
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State | CA
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Zip | 94533-6717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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