Provider Demographics
NPI:1265458699
Name:LEIDIG, SILVIA A (MSW)
Entity Type:Individual
Prefix:MS
First Name:SILVIA
Middle Name:A
Last Name:LEIDIG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6692
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-6692
Mailing Address - Country:US
Mailing Address - Phone:805-644-0678
Mailing Address - Fax:805-644-1848
Practice Address - Street 1:4243 TELEGRAPH RD # 2
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3705
Practice Address - Country:US
Practice Address - Phone:805-644-0678
Practice Address - Fax:805-644-1848
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS156871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical