Basic Information
| Provider Information | |||||||||
| NPI: | 1790131969 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEARCE | ||||||||
| FirstName: | LESLEY | ||||||||
| MiddleName: | WELLS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12927 SLEEPY WIND ST | ||||||||
| Address2: | |||||||||
| City: | MOORPARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930212935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109893092 | ||||||||
| FaxNumber: | 8055303989 | ||||||||
| Practice Location | |||||||||
| Address1: | 1820 MARRON RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920081177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604340125 | ||||||||
| FaxNumber: | 7604344531 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2016 | ||||||||
| LastUpdateDate: | 05/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HA8100 | CA | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.