Dominique Rosa Leslie

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

835 Hyde St
San Francisco, CA 94109-5927

Phone

(628) 235-4366

NPI assigned

Dec 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Forward SF, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Francisco, CA
  • NPI 1619007986
  NPD (past)

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1215533799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 HOWARD ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032822",
            "telephone_number": "628-235-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 HYDE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095927",
            "telephone_number": "628-235-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "DOMINIQUE",
        "middle_name": "ROSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94-2335626",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CommunityForwardSF.org",
            "affiliation": "N",
            "address_1": "835 Hyde St",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941095927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.communityforwardsf.org",
            "affiliation": "N",
            "address_1": "835 Hyde St",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941095927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Lesky
• Daniel Nathan Lesky, MD
• Lesley J Anderson MD PC
• Leslie a. Squires, MD., Inc.
• Leslie Silverman DDS Inc a Prof Corp
• Kieron S. Leslie, MD
• Alban Lesne, CADC-I #CI29780520
• Lesprit Pyschiatry and Wellness a Professional Nursing Corporation
• Micah Lessans, MSW
• David Michael Lesseps, L.AC.

• Community Health Worker in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.