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General NPI Number Information
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NPI Number | 1780847079
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Entity Type | Individual
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Provider Name | LESLIE DARGIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 161 THUNDER DR 203
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City | VISTA
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State | CA
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Zip | 92083-6016
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Country | US
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Telephone | 760-414-1567
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Fax |
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Provider Business Mailing Address
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Address Line | 26895 ALISO CREEK RD STE #B-153
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City | ALISO VIEJO
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State | CA
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Zip | 92656-5301
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18201
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License Number State | CA
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