| Dr. Leslie Liberty | |
|
924 N Yosemite St Stockton CA 95203-2217 | |
| (209) 401-5741 | |
| Not Available |
| Full Name | Dr. Leslie Liberty |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 924 N Yosemite St, Stockton, California |
| Authorized Official Name and Position | Leslie S Liberty (BUSINESS OWNER) |
| Authorized Official Contact | 2094015741 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Leslie Liberty Po Box 4212 Stockton CA 95204-0212 Ph: (209) 401-5741 | Dr. Leslie Liberty 924 N Yosemite St Stockton CA 95203-2217 Ph: (209) 401-5741 |
| NPI Number | 1932791985 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 02/10/2021 |
| Certification Date | 02/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932791985 | NPI | - | NPPES |
| LCSW7173 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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