Provider Demographics
NPI:1851571947
Name:ESCOBAR, LEYNZDIANA (CAS)
Entity Type:Individual
Prefix:
First Name:LEYNZDIANA
Middle Name:
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:LEYNZDIANA
Other - Middle Name:
Other - Last Name:FELIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAS
Mailing Address - Street 1:20710 LEAPWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3642
Mailing Address - Country:US
Mailing Address - Phone:310-324-0447
Mailing Address - Fax:310-324-0147
Practice Address - Street 1:20710 LEAPWOOD AVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3642
Practice Address - Country:US
Practice Address - Phone:310-324-0447
Practice Address - Fax:310-324-0147
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)