MEDICARE: LESLIE ANN KLEIMAN 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	MFC31992	CA

General Provider Information

NPI Number	:	1861538589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE ANN KLEIMAN MFT

Provider Business Mailing Address
First Line	:	17937 AVENIDA ALOZDRA
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-1534
Country	:	US
Telephone Number	:	858-451-7824
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 CAMINO DEL RIO N
Second Line	:	SUITE 400
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-5720
Country	:	US
Telephone Number	:	619-899-2825
Fax Number	:

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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