Provider Demographics
NPI:1871638742
Name:LEONG, HYMAN RAY (MA, MFTI)
Entity Type:Individual
Prefix:MR
First Name:HYMAN
Middle Name:RAY
Last Name:LEONG
Suffix:
Gender:M
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 W ORANGEWOOD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1978
Mailing Address - Country:US
Mailing Address - Phone:714-634-8500
Mailing Address - Fax:
Practice Address - Street 1:2127 W ORANGEWOOD AVE STE B
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1978
Practice Address - Country:US
Practice Address - Phone:714-634-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC51177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist