Provider Demographics
NPI:1689727794
Name:LEFTIK, ELIZABETH RAUCH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RAUCH
Last Name:LEFTIK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 STONE VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-1200
Mailing Address - Country:US
Mailing Address - Phone:925-314-6354
Mailing Address - Fax:
Practice Address - Street 1:260 STONE VALLEY WAY
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1200
Practice Address - Country:US
Practice Address - Phone:925-314-6354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ56112Medicare UPIN