MEDICARE: CAROLINA LIMA LEAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	106H00000X	Marriage & Family Therapist	CA
2	390200000X	Student in an Organized Health Care Education/Training Program	CA
3	103K00000X	Behavior Analyst	CA
4	101YM0800X	Mental Health Counselor	CA

General Provider Information

NPI Number	:	1811692973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA LIMA LEAL

Provider Business Mailing Address
First Line	:	5418 INGLEWOOD BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6253
Country	:	US
Telephone Number	:	310-746-8837
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 TEXAS ST STE 106
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3722
Country	:	US
Telephone Number	:	619-330-5670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2023
Last Update Date	:	01/12/2026

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Directions to “ CAROLINA LIMA LEAL ” Practice Location

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