Individual
ALICE LEYVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT INTERN
Contact information
Practice address
233 BASE LINE RD, BOX 400, LA VERNE, CA 91750-2353
(626) 593-2581
Mailing address
233 BASE LINE RD, BOX 400, LA VERNE, CA 91750-2353
(626) 593-2581
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMF 51062
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7565 A
OUTPATIENT MENTAL HEALTH
CA
Enumeration date
03/21/2007
Last updated
07/08/2007
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