Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 22117 | CA |
NPI | 1003159849 |
---|---|
Provider Name | Leslie Ann Joslin |
First Address | Templeton, CA 93465-8667 |
Second Address | Templeton, CA 93465-9711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 15/01/2016 |