Healthcare Provider Details

I. General information

NPI: 1801257902
Provider Name (Legal Business Name): TAMI LYN LEFFLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31625 HIGHWAY 101 S
SOLEDAD CA
93960-9529
US

IV. Provider business mailing address

31625 HIGHWAY 101 S
SOLEDAD CA
93960-9529
US

V. Phone/Fax

Practice location:
  • Phone: 831-678-5500
  • Fax:
Mailing address:
  • Phone: 831-678-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number89095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: