1942514716 NPI number — MS. LESLEE DONNE COOK LESLEE COOK M.F.T.

Table of content: MS. LESLEE DONNE COOK LESLEE COOK M.F.T. (NPI 1942514716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942514716 NPI number — MS. LESLEE DONNE COOK LESLEE COOK M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
LESLEE
Provider Middle Name:
DONNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LESLEE COOK M.F.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOK
Provider Other First Name:
LESLEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LESLEE COOK, M.F.T.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1942514716
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26663 LATIGO SHORE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MALIBU
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90265-4507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-589-7560
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3231 OCEAN PARK BLVD
Provider Second Line Business Practice Location Address:
SUITE 124
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90405-3221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-617-2577
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2010

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:  MFC12151 , 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)





Copyright © 2007-2025 www.npivalidator.com