Provider Demographics
NPI:1346549771
Name:SARDINAS, LILI M (PHD)
Entity Type:Individual
Prefix:DR
First Name:LILI
Middle Name:M
Last Name:SARDINAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 AVE DOMENECH
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3520
Mailing Address - Country:US
Mailing Address - Phone:787-453-6463
Mailing Address - Fax:787-753-7503
Practice Address - Street 1:283 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3520
Practice Address - Country:US
Practice Address - Phone:787-453-6463
Practice Address - Fax:787-753-7503
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3955103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical