MEDICARE: MS. LESLEY MARLA SILVERSTONE MA, MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	100518	CA

General Provider Information

NPI Number	:	1043704281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LESLEY MARLA SILVERSTONE MA, MFT

Provider Business Mailing Address
First Line	:	2766 SONOMA ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-6064
Country	:	US
Telephone Number	:	310-850-6067
Fax Number	:

Provider Business Practice Location Address
First Line	:	827 DEEP VALLEY DR STE 207
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3654
Country	:	US
Telephone Number	:	310-850-6067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2018
Last Update Date	:	06/20/2018

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