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NPI Code Detail

MEDICARE: LILIA VAN

MEDICARE: LILIA VAN
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
1101YM0800XMental Health Counselor115956CA
21041C0700XClinical Social Worker138234CA
3104100000XSocial Worker115956CA

General Provider Information

NPI Number : 1255114864
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILIA VAN
Provider Business Mailing Address
First Line : PO BOX 8620
Second Line :
City : PASADENA
State : CA
Zip : 91109-8608
Country : US
Telephone Number : 646-941-7645
Fax Number :
Provider Business Practice Location Address
First Line : 680 E COLORADO BLVD STE 180
Second Line :
City : PASADENA
State : CA
Zip : 91101-6144
Country : US
Telephone Number : 646-941-7645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2023
Last Update Date : 05/26/2026

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Directions to “ LILIA VAN ” 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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