MEDICARE: KIMBERLIN BORCA LEON, LICENSED CLINICAL SOCIAL WORKER, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1508708389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMBERLIN BORCA LEON, LICENSED CLINICAL SOCIAL WORKER, INC.

Provider Business Mailing Address
First Line	:	1357 HOPKINS DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1627
Country	:	US
Telephone Number	:	669-333-6491
Fax Number	:

Provider Business Practice Location Address
First Line	:	1357 HOPKINS DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1627
Country	:	US
Telephone Number	:	916-246-6290
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	KIMBERLIN LEON
Credential	:
Telephone Number	:	669-333-6491

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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