Most Relevant Information
Provider Data
| NPI Number: | 1003370941 |
| Provider Name: | CORRINE MARIE LEIKAM PSY.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 30262 |
Most Important Dates
| Enumeration Date: | 01/24/2019 |
| Last Updated: | 01/24/2019 |
Provider Practice Location
15235 BURBANK BLVD STE B4
VAN NUYS
CA
914113556
Practice Location Phone/Fax
| Phone: | 2139276770 |
| Fax: |
Provider Mailing Location
PO BOX 3181
THOUSAND OAKS
CA
913590181
Provider Mailing Phone/Fax
| Phone: | 8183243727 |
| Fax: |