Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist | CA |
NPI | 1457786170 |
---|---|
Provider Name | Dr. Tikesha Leslie-Jones |
First Address | Fresno, CA 93723-8103 |
Second Address | Fresno, CA 93706-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |