Healthcare Provider Details

I. General information

NPI: 1205395761
Provider Name (Legal Business Name): KAREN LEYVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 N FRUIT AVE STE 102
FRESNO CA
93711-3062
US

IV. Provider business mailing address

1821 N LASSEN AVE
KERMAN CA
93630-9500
US

V. Phone/Fax

Practice location:
  • Phone: 559-493-5609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: