Provider Demographics
NPI:1720211931
Name:LEYVA, MARTIN
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:
Last Name:LEYVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1942
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-1942
Mailing Address - Country:US
Mailing Address - Phone:805-708-6305
Mailing Address - Fax:
Practice Address - Street 1:25 W ANAPAMU ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5149
Practice Address - Country:US
Practice Address - Phone:805-730-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)