Individual
MARVIN ENRIQUE LEIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
10605 BALBOA BLVD, #100, GRANADA HILLS, CA 91344-6342
(818) 832-2400
Mailing address
10605 BALBOA BLVD, #100, GRANADA HILLS, CA 91344-6342
(818) 832-2400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
632444
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
632444
CA
Other
Enumeration date
04/02/2009
Last updated
06/09/2021
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