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General NPI Number Information
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NPI Number | 1952876260
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Entity Type | Individual
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Provider Name | LESLIE DENOGEAN AGACNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 2801 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90806-1701
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Country | US
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Telephone | 562-933-3373
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Fax |
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Provider Business Mailing Address
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Address Line | 9718 ALIWIN ST
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City | DOWNEY
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State | CA
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Zip | 90240-2503
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Country | US
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Telephone | 562-299-2311
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | NP95009413
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License Number State | CA
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