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General NPI Number Information
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NPI Number | 1417561226
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Entity Type | Individual
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Provider Name | LESLIE ALVAREZ
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Gender | Female
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 801 S RANCHO DR STE A2
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City | LAS VEGAS
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State | NV
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Zip | 89106-3870
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Country | US
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Telephone | 702-636-8729
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 E 111TH ST APT 101
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City | LOS ANGELES
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State | CA
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Zip | 90059-2051
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Country | US
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Telephone | 323-674-6595
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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