Healthcare Provider Details

I. General information

NPI: 1235092610
Provider Name (Legal Business Name): ERNESTO M ARTEAGA-LEYVA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 LABRADOR CT
NEWMAN CA
95360-1746
US

IV. Provider business mailing address

1174 LABRADOR CT
NEWMAN CA
95360-1746
US

V. Phone/Fax

Practice location:
  • Phone: 925-550-1360
  • Fax: 925-550-1360
Mailing address:
  • Phone: 925-550-1360
  • Fax: 925-550-1360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: