Active NPI
Herlyn McIntosch Leiva
- Optometrist
- San Jacinto, CA
National Provider Identifier
1003786633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 36096
- Practice address
- 23119 Soboba Rd
San Jacinto, CA 92583-2904 - Phone
- (951) 654-0803
- NPI assigned
- Nov 8, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 36096 | CA | Primary |
Addresses
Primary practice location
23119 Soboba Rd
San Jacinto, CA 92583-2904
Mailing address
23945 Pico Ave
Menifee, CA 92585-9549
Phone (951) 220-5905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36096 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762560000000",
"number": "1003786633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23945 PICO AVE",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925859549",
"telephone_number": "951-220-5905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23119 SOBOBA RD",
"city": "SAN JACINTO",
"state": "CA",
"postal_code": "925832904",
"telephone_number": "951-654-0803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSCH LEIVA",
"first_name": "HERLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-08",
"last_updated": "2025-11-08",
"certification_date": "2025-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "36096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jacinto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.