Healthcare Provider Details

I. General information

NPI: 1699699751
Provider Name (Legal Business Name): LORI LEBLANC LEYVA MA, COUNSELING PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 MCDOUGALL ST
CASTROVILLE CA
95012-2523
US

IV. Provider business mailing address

10601 MCDOUGALL ST
CASTROVILLE CA
95012-2523
US

V. Phone/Fax

Practice location:
  • Phone: 831-633-5975
  • Fax:
Mailing address:
  • Phone: 831-633-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number260038301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: