Provider Demographics
NPI:1598018558
Name:LEYVA, KATHLEEN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:LEYVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:LEYVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:919 VILLAGE CTR STE 7
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3599
Mailing Address - Country:US
Mailing Address - Phone:925-322-1747
Mailing Address - Fax:
Practice Address - Street 1:919 VILLAGE CTR STE 7
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3599
Practice Address - Country:US
Practice Address - Phone:925-322-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84265106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist