Provider Demographics
NPI:1396019113
Name:LEYVA, CHRISTINE CHANG (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:CHANG
Last Name:LEYVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:SUSAN
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:231 EMPORIA BLVD
Mailing Address - Street 2:#7
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4266
Mailing Address - Country:US
Mailing Address - Phone:210-643-3687
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER ST # 116B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist