Provider Demographics
NPI:1679765267
Name:DE LA FLOR, LESLIE CAROL (NP)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:CAROL
Last Name:DE LA FLOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:LESLIE
Other - Middle Name:CAROL
Other - Last Name:DUPERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:25592 THE OLD RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1705
Mailing Address - Country:US
Mailing Address - Phone:661-288-1405
Mailing Address - Fax:661-705-2090
Practice Address - Street 1:25592 THE OLD RD
Practice Address - Street 2:
Practice Address - City:STEVENSON RANCH
Practice Address - State:CA
Practice Address - Zip Code:91381-1705
Practice Address - Country:US
Practice Address - Phone:661-288-1405
Practice Address - Fax:661-705-2090
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412018363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health