Individual provider Active NPI

Leslie Dawn Laine, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1265019020
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95031916 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Mar 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95031916 CA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95198633 CA

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 57326
Los Angeles, CA 90074-0001
Phone (858) 249-6748

Other practice location 1

350 Dickinson St
San Diego, CA 92103-1913
Phone (800) 926-8273

Other practice location 2

6363 Greenwich Dr
San Diego, CA 92122-5947
Phone (800) 926-8273

Other practice location 3

2185 Citracado Pkwy
Escondido, CA 92029-4159
Phone (760) 881-3012

Other practice location 4

6645 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-8273

Other practice location 5

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-8273

Other names 1

  • Leslie Lutke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241018002432 CA Practitioner - Nurse Practitioner 5092247767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1963 4TH Ave
San Diego, CA 92101-2394
Phone (619) 233-3432

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753

6645 Alvarado Rd
San Diego, CA 92120-5208
Phone (858) 249-6748

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-5273

8950 Villa la Jolla Dr
La Jolla, CA 92037-1714
Phone (858) 249-6748

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 249-6748

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 249-6748

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Oct 1, 2024 Accepting new patients
Community Research Foundation Inc CurrentSince Oct 28, 2024 Accepting new patients
Regents of the University of California CurrentSince Oct 1, 2024 Accepting new patients
Correctional Healthcare Partners, Inc. PastSince Mar 1, 2021 Accepting new patients

Locations

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

8950 Villa La Jolla Dr
Ste C106
La Jolla, CA 92037

File 57326
Los Angeles, CA 90074

350 Dickinson St
San Diego, CA 92103
Phone (619) 543-6635

6645 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3172

1202 Morena Blvd
Ste 100
San Diego, CA 92110
Phone (619) 276-8112

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

4510 Executive Dr
Ste 315
San Diego, CA 92121
Phone (858) 534-8019

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175

1963 4th Ave
San Diego, CA 92101
Phone (619) 233-3432

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1265019020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001",
            "telephone_number": "858-249-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Dickinson St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921031913",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6363 Greenwich Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921225947",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2185 Citracado Pkwy",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920294159",
            "country_code": "US",
            "telephone_number": "760-881-3012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6645 Alvarado Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921205208",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6655 Alvarado Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921205208",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAINE",
        "first_name": "LESLIE",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95031916",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95198633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "LUTKE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.