Fernando Andre Leyva, PHD.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2003 Issued in MD

Practice address

921 Russell Ave
Gaithersburg, MD 20879-3252

Phone

(301) 977-5675

Fax

(301) 963-9070

NPI assigned

Feb 16, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1356580211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793252",
            "telephone_number": "301-977-5675",
            "fax_number": "301-963-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793252",
            "telephone_number": "301-977-5675",
            "fax_number": "301-963-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYVA",
        "first_name": "FERNANDO",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-16",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "2003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "921 Russell Ave",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208793252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittany Kristen Lewis-Fooks, LCPC
• Natalie Lewis
• Nina Lewis
• Terry A Lewis, MSW
• Kristy Leyden
• Lun Li
• Mary Lan Li, PHARMD
• Min Li
• Shengyun Li, MD, PHD
• Andrea Eleni Liacouras, AU.D., CCC-A

• Psychologist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.