Active NPI
Leisa Kathleen Ensworth, M.A.
- Audiologist
- La Palma, CA
National Provider Identifier
1104202159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU1155
- Practice address
- 7851 Walker St Ste 206
La Palma, CA 90623-1746 - Phone
- (714) 523-4327
- NPI assigned
- Jul 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU1155 | CA | Primary |
Addresses
Primary practice location
7851 Walker St Ste 206
La Palma, CA 90623-1746
Mailing address
7851 Walker St Ste 206
La Palma, CA 90623-1746
Phone (714) 523-4327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU1155 | CA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bristol Park Medical Group, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Costa Mesa, CA
- NPI 1043266760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438300800000",
"number": "1104202159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7851 WALKER ST STE 206",
"city": "LA PALMA",
"state": "CA",
"postal_code": "906231746",
"telephone_number": "714-523-4327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7851 WALKER ST STE 206",
"city": "LA PALMA",
"state": "CA",
"postal_code": "906231746",
"telephone_number": "714-523-4327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENSWORTH",
"first_name": "LEISA",
"middle_name": "KATHLEEN",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-31",
"last_updated": "2015-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU1155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Palma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.