Individual
LESLIE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4077 MENLO AVE APT 4, SAN DIEGO, CA 92105-1945
(619) 408-4680
(619) 291-8819
Mailing address
2358 UNIVERSITY AVE # 639, SAN DIEGO, CA 92104-2720
(619) 408-4680
(619) 291-8819
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN264695
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VN264695
NURSING LICENSE NUMBER
CA
Enumeration date
07/15/2015
Last updated
07/15/2015
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