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General NPI Number Information
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NPI Number | 1710994504
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Entity Type | Individual
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Provider Name | LESLIE A. LEM M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 3105 FITE CIR STE 101
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City | SACRAMENTO
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State | CA
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Zip | 95827-1812
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Country | US
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Telephone | 916-754-2175
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Fax |
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Provider Business Mailing Address
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Address Line | 2429 FALLWATER LN
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City | CARMICHAEL
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State | CA
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Zip | 95608-7403
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Country | US
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Telephone | 916-266-1270
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37279
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License Number State | CA
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