NPIMap

Individual provider Active NPI

Asya Monique Leslie, PHD

  • Psychologist
  • El Dorado Hills, CA
National Provider Identifier
1568022531
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30961 Issued in CA
Practice address
5047 Robert J Mathews Pkwy Ste 302
El Dorado Hills, CA 95762-5748
Phone
(916) 992-4114
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X B1-0011259 DE
Clinical Psychologist 103TC0700X B1-0011259 DE
Clinical Psychologist 103TC0700X 30961 CA
Forensic Psychologist 103TF0200X B1-0011259 DE
Forensic Psychologist 103TF0200X 30961 CA
Psychologist 103T00000X 30961 CA Primary

Addresses

Primary practice location

5047 Robert J Mathews Pkwy Ste 302
El Dorado Hills, CA 95762-5748

Mailing address

PO Box 11655
Philadelphia, PA 19116-0655

Other practice location 1

1230 N Kimball Ave Ste 140-A
Southlake, TX 76092-4707
Phone (833) 667-7924

Other names 1

  • Dr. A. Monique Leslie Professional name

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
B1-0011259DEMDForensic Psychologist
30961CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sara Bowerman, PH.D., a Professional Corporation Clinical PastSince May 31, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1568022531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11655",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191160655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 ROBERT J MATHEWS PKWY STE 302",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957625748",
            "telephone_number": "916-992-4114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 N Kimball Ave Ste 140-A",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760924707",
            "country_code": "US",
            "telephone_number": "833-667-7924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "ASYA MONIQUE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2021-07-02",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DE",
            "license": "B1-0011259",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0011259",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30961",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "DE",
            "license": "B1-0011259",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "30961",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A. MONIQUE",
            "last_name": "LESLIE",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.