Provider Demographics
NPI:1992726715
Name:JANSEN, LESLIE ANN (RNFA)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:JANSEN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26651 LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3934
Mailing Address - Country:US
Mailing Address - Phone:949-395-6661
Mailing Address - Fax:949-383-4808
Practice Address - Street 1:26651 LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3934
Practice Address - Country:US
Practice Address - Phone:949-395-6661
Practice Address - Fax:949-383-4808
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556500163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant