Individual provider Active NPI

Omar B Leslie, LCSW

  • Social Worker
  • Martinez, CA
National Provider Identifier
1215371133
Registry record updated Mar 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW28460 Issued in CA
Practice address
150 Muir Rd
Martinez, CA 94553-4668
Phone
(916) 384-7397
NPI assigned
Apr 22, 2013
Last updated
Mar 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW28460 CA Primary

Addresses

Primary practice location

150 Muir Rd
Martinez, CA 94553-4668

Mailing address

444 Georgia St
Vallejo, CA 94590-6005
Phone (707) 563-0157

Other practice location 1

444 Georgia St
Vallejo, CA 94590-6005
Phone (707) 563-0157

Other practice location 2

1625 Filbert St
Oakland, CA 94607-2890
Phone (510) 663-9092

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

State licenses

LicenseStateTypeSpecialty
LCSW28460CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Solutions CurrentSince Aug 1, 2023 Accepting new patients
Veterans Home of California Barstow Past Accepting new patients

Locations

444 Georgia St
Vallejo, CA 94590
Phone (707) 563-0157

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1215371133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 GEORGIA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945906005",
            "telephone_number": "707-563-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUIR RD",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534668",
            "telephone_number": "916-384-7397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Georgia St",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945906005",
            "country_code": "US",
            "telephone_number": "707-563-0157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1625 Filbert St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946072890",
            "country_code": "US",
            "telephone_number": "510-663-9092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "OMAR",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW28460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2024; 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.