Provider Demographics
NPI:1528294725
Name:KWAIT, LESLIE JEAN (NP)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:JEAN
Last Name:KWAIT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:JEAN
Other - Last Name:KWAIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25240 HANCOCK AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5991
Mailing Address - Country:US
Mailing Address - Phone:951-200-7800
Mailing Address - Fax:
Practice Address - Street 1:25240 HANCOCK AVE STE 120
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5991
Practice Address - Country:US
Practice Address - Phone:951-200-7800
Practice Address - Fax:951-973-7760
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily