Provider Demographics
NPI:1083310890
Name:WILSON, LESLIE MARGARITA (CMPSS)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:MARGARITA
Last Name:WILSON
Suffix:
Gender:F
Credentials:CMPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 ROSIN CT STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1645
Mailing Address - Country:US
Mailing Address - Phone:916-906-5434
Mailing Address - Fax:
Practice Address - Street 1:3840 ROSIN CT STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1645
Practice Address - Country:US
Practice Address - Phone:916-906-5434
Practice Address - Fax:916-237-8073
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-ZLPMVC175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist