MEDICARE: MRS. VERONICA MARION LEYVA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker	77506	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	101YM0800X	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1437412228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA MARION LEYVA LCSW

Provider Business Mailing Address
First Line	:	3609 10TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4114
Country	:	US
Telephone Number	:	323-298-3680
Fax Number	:

Provider Business Practice Location Address
First Line	:	3609 10TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4114
Country	:	US
Telephone Number	:	323-298-3680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2012
Last Update Date	:	05/19/2025

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