Individual provider Active NPI

Leslie Hodge

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1780085449
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
202 E Airport Dr Ste 265
San Bernardino, CA 92408-3444
Phone
(925) 819-8207
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA
Case Manager/Care Coordinator 171M00000X
Community Health Worker 172V00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X CA Primary

Addresses

Primary practice location

202 E Airport Dr Ste 265
San Bernardino, CA 92408-3444

Mailing address

PO Box 6044
Tampa, FL 33608-0044
Phone (925) 819-8207

Other practice location 1

390 40th St
Oakland, CA 94609-2633
Phone (510) 653-5040

Other practice location 2

6051 N Fresno St Ste 201
Fresno, CA 93710-5280
Phone (559) 840-5943

Other practice location 3

1630 E Shaw Ave Ste 150
Fresno, CA 93710
Phone (559) 248-8550

Other names 1

  • Leslie Anderson Former 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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1780085449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6044",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336080044",
            "telephone_number": "925-819-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E AIRPORT DR STE 265",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083444",
            "telephone_number": "925-819-8207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 40th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092633",
            "country_code": "US",
            "telephone_number": "510-653-5040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6051 N Fresno St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937105280",
            "country_code": "US",
            "telephone_number": "559-840-5943",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 E Shaw Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93710",
            "country_code": "US",
            "telephone_number": "559-248-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGE",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.