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NPI Code Detail

MEDICARE: MRS. LILIA ROA

MEDICARE: MRS. LILIA ROA
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
1172V00000XCommunity Health Worker
2225400000XRehabilitation Practitioner
3373H00000XDay Training/Habilitation Specialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023483344
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LILIA ROA
Provider Business Mailing Address
First Line : 760 MOUNTAIN VIEW ST
Second Line :
City : ALTADENA
State : CA
Zip : 91001-4925
Country : US
Telephone Number : 626-798-6793
Fax Number :
Provider Business Practice Location Address
First Line : 760 MOUNTAIN VIEW ST
Second Line :
City : ALTADENA
State : CA
Zip : 91001-4996
Country : US
Telephone Number : 626-375-7823
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2015
Last Update Date : 05/05/2025

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Directions to “ MRS. LILIA ROA ” Practice Location

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