Healthcare Provider Details

I. General information

NPI: 1073380796
Provider Name (Legal Business Name): LEAH BIBLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 SPRUCE ST STE A&B
RIVERSIDE CA
92507-2464
US

IV. Provider business mailing address

8939 6TH AVE
HESPERIA CA
92345-3957
US

V. Phone/Fax

Practice location:
  • Phone: 951-396-6870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: