1760404644 NPI number — MS. LESLIE JEAN TREMAINE LESLIE TREMAINE

Table of content: MS. LESLIE JEAN TREMAINE LESLIE TREMAINE (NPI 1760404644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760404644 NPI number — MS. LESLIE JEAN TREMAINE LESLIE TREMAINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TREMAINE
Provider First Name:
LESLIE
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LESLIE TREMAINE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KRUMLAND
Provider Other First Name:
LESLIE
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LESLIE TREMAINE LMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760404644
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 PLEASANT HILL RD
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
PLEASANT HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94523-2003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-977-9633
Provider Business Mailing Address Fax Number:
925-228-6844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 PLEASANT HILL RD
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
PLEASANT HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94523-2003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-977-9633
Provider Business Practice Location Address Fax Number:
925-228-6844
Provider Enumeration Date:
07/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 14363 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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