Basic Information
| Provider Information | |||||||||
| NPI: | 1073913695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CACHU | ||||||||
| FirstName: | LILLIANA | ||||||||
| MiddleName: | OLIVIA | ||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CORIA | ||||||||
| OtherFirstName: | LILLIANA | ||||||||
| OtherMiddleName: | OLIVIA | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LMFT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5740 RALSTON ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930036009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052893383 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4651 TELEPHONE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056545570 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2014 | ||||||||
| LastUpdateDate: | 07/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 103654 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.