Individual
BRENT RAUL LEYVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6809 INDIANA AVE, RIVERSIDE, CA 92506-4221
(951) 774-1338
Mailing address
1094 NORRTHPARK BLVD, SAN BERNARDINO, CA 92407
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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