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NPI Code Detail

MEDICARE: LESLIE SIAM VAIRAMOODY

MEDICARE: LESLIE SIAM VAIRAMOODY
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
1106H00000XMarriage & Family TherapistCA

General Provider Information

NPI Number : 1699082271
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE SIAM VAIRAMOODY
Provider Business Mailing Address
First Line : 4049 MORRISON WAY
Second Line :
City : ROSEVILLE
State : CA
Zip : 95747-8790
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1624 SANTA CLARA DR STE 145
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3500
Country : US
Telephone Number : 916-779-2455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2010
Last Update Date : 05/03/2019

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Directions to “ LESLIE SIAM VAIRAMOODY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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