Provider Demographics
NPI:1376921411
Name:REYNOLDS, LEIGHTON JAMES I (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEIGHTON
Middle Name:JAMES
Last Name:REYNOLDS
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25000 AVENUE STANFORD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1224
Mailing Address - Country:US
Mailing Address - Phone:661-478-0667
Mailing Address - Fax:661-254-1404
Practice Address - Street 1:25000 AVENUE STANFORD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1224
Practice Address - Country:US
Practice Address - Phone:661-478-0667
Practice Address - Fax:661-254-1404
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
NM000000102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst