Provider Demographics
NPI:1427613900
Name:LENSING, WESTON WILLIAM
Entity type:Individual
Prefix:
First Name:WESTON
Middle Name:WILLIAM
Last Name:LENSING
Suffix:
Gender:M
Credentials:
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 749
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:CA
Mailing Address - Zip Code:93510-0749
Mailing Address - Country:US
Mailing Address - Phone:661-406-9518
Mailing Address - Fax:
Practice Address - Street 1:3502 LYONS AVE
Practice Address - Street 2:STE 304A
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-406-9518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician