Provider Demographics
NPI:1750037123
Name:LEYVA, ANA CRISTINA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CRISTINA
Last Name:LEYVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E ARRELLAGA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1903
Mailing Address - Country:US
Mailing Address - Phone:805-882-2400
Mailing Address - Fax:
Practice Address - Street 1:111 E ARRELLAGA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1903
Practice Address - Country:US
Practice Address - Phone:805-882-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC7363101YP2500X
CAAMFT117601106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAMFT117601OtherBOARD OF BEHAVIORAL SCIENCES
CAAPCC7363OtherBOARD OF BEHAVIORAL SCIENCES