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General NPI Number Information
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NPI Number | 1437607983
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Entity Type | Individual
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Provider Name | LESLIE JOHN KILEY-SMITH RN
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Gender | Male
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 1111 MARKET ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94103
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Country | US
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Telephone | 415-863-3883
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Fax | 415-863-7343
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Provider Business Mailing Address
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Address Line | 163A NOE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1207
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Country | US
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Telephone | 415-235-8172
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 469122
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 469122
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WC1400X
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Taxonomy Name | College Health Registered Nurse
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License Number | 469122
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License Number State | CA
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Taxonomy #4
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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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