Provider Demographics
NPI:1992850788
Name:LEYVA, RUBY (MFT)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:LEYVA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 COLERIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5408
Mailing Address - Country:US
Mailing Address - Phone:415-647-1886
Mailing Address - Fax:
Practice Address - Street 1:3150 18TH ST
Practice Address - Street 2:SUITE 426
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2074
Practice Address - Country:US
Practice Address - Phone:415-647-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist