Individual
LEZLIE SCALIATINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1625 TERRACE WAY, STE C, SANTA ROSA, CA 95404-3035
(510) 206-7917
Mailing address
1625 TERRACE WAY, STE C, SANTA ROSA, CA 95404-3035
(510) 206-7917
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC03890G
—
CA
Enumeration date
08/20/2007
Last updated
01/19/2016
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