Individual
MS. LESLIE SUSAN KO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMT, BCTMB
Contact information
Practice address
1611 SAN PABLO AVE STE 1, BERKELEY, CA 94702-1367
(916) 416-0491
Mailing address
1466 CEDAR ST, BERKELEY, CA 94702-1221
(916) 416-0491
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225700000X
Massage Therapist
Primary
327
CA
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
03/27/2018
Last updated
03/30/2025
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