DR. LESLIE LIBERTY NPI 1932791985

NPI Information

NPI: 1932791985
Provider Name: DR. LESLIE LIBERTY
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
924 N YOSEMITE ST
STOCKTON, CA
ZIP 95203
Phone: (209) 401-5741
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DR. LESLIE LIBERTY is an adult mental health clinic center in Stockton, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. DR. LESLIE LIBERTY NPI is 1932791985. The provider is registered as an organization entity type.

The provider's business location address is:

924 N YOSEMITE ST
STOCKTON, CA
ZIP 95203-217
Phone: (209) 401-5741

The provider's authorized official is Leslie S Liberty .
The authorized official title is Business Owner and has the following contact phone number (209) 401-5741.

The enumeration date for this NPI number is 2/10/2021 and was last updated on 2/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LCSW7173	OTHER	CALIFORNIA	BOARD OF BEHAVIORAL SCIENCES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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