Healthcare Provider Details

I. General information

NPI: 1730422270
Provider Name (Legal Business Name): LILIT ZILIFYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N CENTRAL AVE # 310
GLENDALE CA
91202-2937
US

IV. Provider business mailing address

1010 N CENTRAL AVE # 310
GLENDALE CA
91202-2937
US

V. Phone/Fax

Practice location:
  • Phone: 819-724-9770
  • Fax:
Mailing address:
  • Phone: 818-724-9770
  • Fax: 818-484-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number92389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: