MEDICARE: LEEZA CAUDILLO

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	104100000X	Social Worker	LCSW-22119	AZ

General Provider Information

NPI Number	:	1912866500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEEZA CAUDILLO

Provider Business Mailing Address
First Line	:	3580 W INA RD STE 220
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2276
Country	:	US
Telephone Number	:	520-200-1382
Fax Number	:

Provider Business Practice Location Address
First Line	:	3580 W INA RD STE 220
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2276
Country	:	US
Telephone Number	:	520-200-1382
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ LEEZA CAUDILLO ” Practice Location

Language	Start Address	Practice Location

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