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NPI Code Detail

MEDICARE: LESLI RECENDIZ GONZALEZ

MEDICARE:   LESLI  RECENDIZ GONZALEZ
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
1373H00000XDay Training/Habilitation SpecialistCA
2373H00000XDay Training/Habilitation Specialist
3172V00000XCommunity Health Worker
4225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1457122954
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLI RECENDIZ GONZALEZ
Provider Business Mailing Address
First Line : 1907 BOYS REPUBLIC DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5447
Country : US
Telephone Number : 909-628-1217
Fax Number : 909-306-5427
Provider Business Practice Location Address
First Line : 3608 STEVE MCQUEEN DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5455
Country : US
Telephone Number : 909-740-3138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2024
Last Update Date : 12/10/2025

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Directions to “ LESLI RECENDIZ GONZALEZ ” Practice Location

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