Healthcare Provider Details

I. General information

NPI: 1629120027
Provider Name (Legal Business Name): CARMELLA LEIPZIG R.N.C., M.A., M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17337 VENTURA BLVD STE 206
ENCINO CA
91316-4926
US

IV. Provider business mailing address

8125 CANBY AVE UNIT 5
RESEDA CA
91335-7523
US

V. Phone/Fax

Practice location:
  • Phone: 818-995-4477
  • Fax: 818-995-4171
Mailing address:
  • Phone: 818-885-7234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 30592
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN 327213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: