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NPI Code Detail

MEDICARE: DR. LESLIE ANNE ROSS PSY.D.

MEDICARE: DR. LESLIE ANNE ROSS PSY.D.
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
1103T00000XPsychologistPSY21187CA

General Provider Information

NPI Number : 1659498160
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE ANNE ROSS PSY.D.
Provider Business Mailing Address
First Line : 14380 W SUNSET BLVD
Second Line :
City : PACIFIC PALISADES
State : CA
Zip : 90272-3935
Country : US
Telephone Number : 213-807-1830
Fax Number : 213-251-3673
Provider Business Practice Location Address
First Line : 711 S NEW HAMPSHIRE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-1831
Country : US
Telephone Number : 213-807-1830
Fax Number : 213-251-3673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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