Provider Demographics
NPI:1417067802
Name:SELBY, LEIGH ANNE (PSY D)
Entity type:Individual
Prefix:DR
First Name:LEIGH ANNE
Middle Name:
Last Name:SELBY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3085
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-3085
Mailing Address - Country:US
Mailing Address - Phone:805-604-6990
Mailing Address - Fax:
Practice Address - Street 1:2000 OUTLET CENTER DR
Practice Address - Street 2:SUITE 225
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0607
Practice Address - Country:US
Practice Address - Phone:805-604-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19994103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical