Leslie K Eaton, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

KS17221 Issued in KS

Practice address

16033 Grissom Ave
Mather, CA 95655

Phone

(916) 366-5420

Fax

(916) 366-5441

NPI assigned

Jan 31, 2006

Reactivated

Apr 15, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Leslie Kay Ellis Eaton Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1174594659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15013 ANILLO WAY",
            "city": "RANCHO MURIETA",
            "state": "CA",
            "postal_code": "95683",
            "telephone_number": "916-320-9039",
            "fax_number": "916-366-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16033 GRISSOM AVE",
            "city": "MATHER",
            "state": "CA",
            "postal_code": "95655",
            "telephone_number": "916-366-5420",
            "fax_number": "916-366-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "LESLIE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2016-04-15",
        "deactivation_date": "2016-02-08",
        "reactivation_date": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "KS17221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "EATON",
            "middle_name": "KAY ELLIS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Buese Durand, LCSW
• Roderick Durant, RT(R)(CT)
• Jessica E Duron
• Connie Dvorkin
• Edward Lee Eaton, M.D.
• Angela Eisentrout-Melton, FNP-C
• Christina Y Eng
• Laurie N. Ericksen, RPH
• Sonja Careaga Espinosa, LCSW
• Philip Joseph Eulie, M.D.

• Psychiatry Physician in Mather, CA
• Providers in Mather, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.