Healthcare Provider Details

I. General information

NPI: 1497208359
Provider Name (Legal Business Name): YANI ESTRELLADO LEYVA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E COLORADO BLVD STE 180&2ND
PASADENA CA
91101-6143
US

IV. Provider business mailing address

1550 CANYON DEL REY BLVD # 1044
SEASIDE CA
93955-3501
US

V. Phone/Fax

Practice location:
  • Phone: 646-453-6777
  • Fax:
Mailing address:
  • Phone: 831-316-4677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY26814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: