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General NPI Number Information
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NPI Number | 1518355445
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Entity Type | Individual
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Provider Name | LESLEY IVY DORFMAN PHD
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Gender | Female
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1337 CAMINO DEL MAR STE B
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City | DEL MAR
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State | CA
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Zip | 92014-2504
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Country | US
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Telephone | 858-279-9676
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Fax | 858-279-0377
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Provider Business Mailing Address
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Address Line | 6973 LINDA VISTA RD
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City | SAN DIEGO
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State | CA
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Zip | 92111-6342
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Country | US
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Telephone | 858-279-9676
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Fax | 858-279-0377
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY26393
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License Number State | CA
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