Provider Demographics
NPI:1699836023
Name:BERZON-LEITELT, DEBRA A (LCSW, MPA)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:A
Last Name:BERZON-LEITELT
Suffix:
Gender:F
Credentials:LCSW, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 MORRISON STREET
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1503
Mailing Address - Country:US
Mailing Address - Phone:818-370-1966
Mailing Address - Fax:
Practice Address - Street 1:2323 E PALMDALE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4957
Practice Address - Country:US
Practice Address - Phone:661-223-3806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS268011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical