Individual
LESLIE AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3530 LOCHNIVAR AVE, SANTA CLARA, CA 95051
(408) 905-6483
Mailing address
3911 LUNETA CT., SAN JOSE, CA 95136
(408) 717-1069
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
32030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
462371412
—
CA
Enumeration date
09/04/2017
Last updated
09/04/2017
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