MEDICARE: LILY LAW NEIMAN BCBA

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
1	106H00000X	Marriage & Family Therapist
2	103K00000X	Behavior Analyst	1-14-15409	CA

General Provider Information

NPI Number	:	1881011021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILY LAW NEIMAN BCBA

Provider Business Mailing Address
First Line	:	16782 VON KARMAN AVE STE 11
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92606-2417
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:	619-374-7134

Provider Business Practice Location Address
First Line	:	12465 LEWIS ST STE 102
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92840-4658
Country	:	US
Telephone Number	:	949-833-2237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	12/11/2019

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