Provider Demographics
NPI:1124451976
Name:JONES, LESLIE STARR (MFC)
Entity type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:STARR
Last Name:JONES
Suffix:
Gender:M
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93464-0381
Mailing Address - Country:US
Mailing Address - Phone:805-680-1334
Mailing Address - Fax:
Practice Address - Street 1:684 ALAMO PINTADO RD
Practice Address - Street 2:SUITE D
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2265
Practice Address - Country:US
Practice Address - Phone:805-680-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health