Healthcare Provider Details

I. General information

NPI: 1477679504
Provider Name (Legal Business Name): LILLIAN HUANG M.A., L.M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 HUGHES AVE STE 708
CULVER CITY CA
90232
US

IV. Provider business mailing address

3831 HUGHES AVE STE 708
CULVER CITY CA
90232-6842
US

V. Phone/Fax

Practice location:
  • Phone: 310-464-6303
  • Fax:
Mailing address:
  • Phone: 310-464-6303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number45064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: