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NPI Code Detail

MEDICARE: LORI LELANI AVILES

MEDICARE: LORI LELANI AVILES
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
1101YA0400XAddiction (Substance Use Disorder) Counselor190077AHNCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225257744
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI LELANI AVILES
Provider Business Mailing Address
First Line : 3125 E 7TH ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-4932
Country : US
Telephone Number : 562-439-7755
Fax Number : 562-438-6891
Provider Business Practice Location Address
First Line : 3125 E 7TH ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-4932
Country : US
Telephone Number : 562-439-7755
Fax Number : 562-438-6891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 07/09/2007

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Directions to “ LORI LELANI AVILES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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