Healthcare Provider Details

I. General information

NPI: 1770438475
Provider Name (Legal Business Name): LILLIAN MARIE TARANTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 ARLINGTON AVE STE 100
LOS ANGELES CA
90018-1300
US

IV. Provider business mailing address

2116 ARLINGTON AVE STE 100
LOS ANGELES CA
90018-1300
US

V. Phone/Fax

Practice location:
  • Phone: 323-334-9000
  • Fax: 323-334-4437
Mailing address:
  • Phone: 323-334-9000
  • Fax: 323-334-4437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: