Provider Demographics
NPI:1356221816
Name:LEYVA, ANGEL DARIEN (CCHW)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:DARIEN
Last Name:LEYVA
Suffix:
Gender:M
Credentials:CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E SAN JOAQUIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2946
Mailing Address - Country:US
Mailing Address - Phone:831-249-1308
Mailing Address - Fax:831-998-8704
Practice Address - Street 1:30 E SAN JOAQUIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2946
Practice Address - Country:US
Practice Address - Phone:831-249-1308
Practice Address - Fax:831-998-8704
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker