Provider Demographics
NPI:1518066091
Name:GOLDSMAN, LILA R (PHD)
Entity Type:Individual
Prefix:DR
First Name:LILA
Middle Name:R
Last Name:GOLDSMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6535 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4905
Mailing Address - Country:US
Mailing Address - Phone:323-933-9492
Mailing Address - Fax:323-651-2437
Practice Address - Street 1:6535 WILSHIRE BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4905
Practice Address - Country:US
Practice Address - Phone:323-933-9492
Practice Address - Fax:323-651-2437
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical