Healthcare Provider Details

I. General information

NPI: 1831640655
Provider Name (Legal Business Name): LILIANA PALACIO CASE MANAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11050 ARTESIA BLVD STE F
CERRITOS CA
90703-2542
US

IV. Provider business mailing address

11050 ARTESIA BLVD STE F
CERRITOS CA
90703-2542
US

V. Phone/Fax

Practice location:
  • Phone: 562-860-8838
  • Fax: 562-860-0248
Mailing address:
  • Phone: 562-860-8838
  • Fax: 562-860-0248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: