Individual
GAIL LOUISE LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 955-1183
Mailing address
845 E ARROW HWY, POMONA, CA 91767-2535
(909) 624-1233
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-UEZKXB
CA
324500000X
Substance Abuse Rehabilitation Facility
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Other
Enumeration date
02/24/2018
Last updated
06/15/2023
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