MEDICARE: LIA G GERMAN

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	106H00000X	Marriage & Family Therapist	162722	CA
2	106H00000X	Marriage & Family Therapist
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1073966388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIA G GERMAN

Provider Business Mailing Address
First Line	:	5198 ARLINGTON AVE # 170
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11801 PIERCE ST # 200-269
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-4408
Country	:	US
Telephone Number	:	951-652-2600
Fax Number	:

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

Provider Enumeration Date	:	07/21/2016
Last Update Date	:	06/16/2026

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