Provider Demographics
NPI:1902604804
Name:LIMAS, ERIC (R1520170823)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:LIMAS
Suffix:
Gender:
Credentials:R1520170823
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 E AMAR RD APT 147
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1718
Mailing Address - Country:US
Mailing Address - Phone:213-281-3634
Mailing Address - Fax:
Practice Address - Street 1:2521 LONG BEACH AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90058-1324
Practice Address - Country:US
Practice Address - Phone:323-263-6642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1520170823101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)