| NPI | 1629574751 |
|---|---|
| Former Name | LESLIE JANET GONZAGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 113013) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2023-09-12 |