Provider Demographics
NPI:1205389194
Name:SOMERA, LESLEY (LVN)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:SOMERA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7237 E SOUTHGATE DR STE E
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2637
Mailing Address - Country:US
Mailing Address - Phone:916-395-9100
Mailing Address - Fax:916-395-9101
Practice Address - Street 1:7237 E SOUTHGATE DR STE E
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2637
Practice Address - Country:US
Practice Address - Phone:916-395-9100
Practice Address - Fax:916-395-9101
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235995164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse