Healthcare Provider Details

I. General information

NPI: 1497334288
Provider Name (Legal Business Name): MICHELLE SUSAN LEIGH MSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 OLIVE DR
BAKERSFIELD CA
93308-4144
US

IV. Provider business mailing address

901 OLIVE DR
BAKERSFIELD CA
93308-4144
US

V. Phone/Fax

Practice location:
  • Phone: 661-215-7500
  • Fax: 661-215-7608
Mailing address:
  • Phone: 661-215-7500
  • Fax: 661-215-7608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number110961
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: