Healthcare Provider Details

I. General information

NPI: 1710810080
Provider Name (Legal Business Name): BELEN LEYVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12215 VICTORY BLVD
NORTH HOLLYWOOD CA
91606-3206
US

IV. Provider business mailing address

49640 252ND ST W
LANCASTER CA
93536-9163
US

V. Phone/Fax

Practice location:
  • Phone: 818-286-0425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF06260050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: