Basic Information
| Provider Information | |||||||||
| NPI: | 1619010683 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | LILLIAN | ||||||||
| MiddleName: | LINDA | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1404 BIRCH ST | ||||||||
| Address2: | |||||||||
| City: | MONTEBELLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906406405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237294535 | ||||||||
| FaxNumber: | 6269616685 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 S 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | LA PUENTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917463211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269618971 | ||||||||
| FaxNumber: | 6269616685 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 1041C0700X | 21738 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.