Provider Demographics
NPI:1952514002
Name:REIDER, LEAH DRUKER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:DRUKER
Last Name:REIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 DANA AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2813
Mailing Address - Country:US
Mailing Address - Phone:650-326-3465
Mailing Address - Fax:650-325-2254
Practice Address - Street 1:230 S CALIFORNIA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1642
Practice Address - Country:US
Practice Address - Phone:650-325-5867
Practice Address - Fax:650-325-2254
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS62251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical