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NPI Code Detail

MEDICARE: SAVANNAH LEYDA

MEDICARE:   SAVANNAH  LEYDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY36369CA

General Provider Information

NPI Number : 1619593548
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH LEYDA
Provider Business Mailing Address
First Line : 222 SE 8TH AVE
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4218
Country : US
Telephone Number : 715-781-7135
Fax Number :
Provider Business Practice Location Address
First Line : 3124 INTERNATIONAL BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2902
Country : US
Telephone Number : 503-352-7333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2020
Last Update Date : 12/22/2025

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Directions to “ SAVANNAH LEYDA ” Practice Location

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