Healthcare Provider Details

I. General information

NPI: 1447730700
Provider Name (Legal Business Name): ERICA D LIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 CHESTNUT AVE
LONG BEACH CA
90813-1674
US

IV. Provider business mailing address

1775 CHESTNUT AVE
LONG BEACH CA
90813-1674
US

V. Phone/Fax

Practice location:
  • Phone: 562-599-8444
  • Fax:
Mailing address:
  • Phone: 562-599-8444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberACSW90270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: