Provider Demographics
NPI:1740172410
Name:CALESTINI, LESLIE
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:CALESTINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:ROEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:166 ASHWORTH DR
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-5435
Mailing Address - Country:US
Mailing Address - Phone:209-256-3916
Mailing Address - Fax:
Practice Address - Street 1:564 MOUNTAIN RANCH RD
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249-9782
Practice Address - Country:US
Practice Address - Phone:209-256-3916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator