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NPI Code Detail

MEDICARE: LILYANN MAXINE FLANAGAN SUDRC II

MEDICARE: LILYANN MAXINE FLANAGAN SUDRC II
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
1101YA0400XAddiction (Substance Use Disorder) Counselor22584CA

General Provider Information

NPI Number : 1164382511
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILYANN MAXINE FLANAGAN SUDRC II
Provider Business Mailing Address
First Line : 3801 BUCK OWENS BLVD STE 105
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93308-4958
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 407 HELEN WAY
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93307-6112
Country : US
Telephone Number : 661-832-3098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2025
Last Update Date : 11/17/2025

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