Provider Demographics
NPI:1487279493
Name:LEYVA, CHRISTI SUSAN
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:SUSAN
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 1:10417 CROSSCREEK TER
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1344
Mailing Address - Country:US
Mailing Address - Phone:619-565-0886
Mailing Address - Fax:
Practice Address - Street 1:10417 CROSSCREEK TER
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1344
Practice Address - Country:US
Practice Address - Phone:619-565-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1190831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical