| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LESLIE PENALOZA | 1720694227 | 2020-09-20 |
Leslie Penaloza is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1720694227. Registration indicates Leslie Penaloza is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Leslie Penaloza |
| Practice Office Address | 612 S MYRTLE AVE STE 100 MONROVIA, CA US |
| Practice Office Telephone | 9096894135 |
| Mailing Address | 612 S MYRTLE AVE MONROVIA, CA 910163406 US |
| Business Telephone | 9096894135 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |