Provider Demographics
NPI:1407853633
Name:TOBIAS, LEIGH B (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:B
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 N LINDEN DR
Mailing Address - Street 2:SUITE 334
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2247
Mailing Address - Country:US
Mailing Address - Phone:310-247-1657
Mailing Address - Fax:310-271-4876
Practice Address - Street 1:462 N LINDEN DR
Practice Address - Street 2:SUITE 334
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2247
Practice Address - Country:US
Practice Address - Phone:310-247-1657
Practice Address - Fax:310-271-4876
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15507103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY15507Medicare ID - Type UnspecifiedPROVIDER NUMBER