Provider Demographics
NPI:1023594892
Name:LEON, KIMBERLIN BORCA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLIN
Middle Name:BORCA
Last Name:LEON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLIN
Other - Middle Name:
Other - Last Name:BORCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7330 25TH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6176
Mailing Address - Country:US
Mailing Address - Phone:669-333-6491
Mailing Address - Fax:
Practice Address - Street 1:7330 25TH AVE APT A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6176
Practice Address - Country:US
Practice Address - Phone:669-333-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90069101Y00000X
CA1209141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor