Provider Demographics
NPI:1497778062
Name:TRAN, LILY LY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:LY
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LILY
Other - Middle Name:M
Other - Last Name:LY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:15525 POMERADO RD STE A7
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2425
Mailing Address - Country:US
Mailing Address - Phone:858-603-2564
Mailing Address - Fax:
Practice Address - Street 1:15525 POMERADO RD STE A7
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2425
Practice Address - Country:US
Practice Address - Phone:858-603-2564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2017-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19543103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical