Provider Demographics
NPI:1609518885
Name:JAMES, LILLIAN KATE
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:KATE
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20601 W VALLEY BLVD STE A104
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8890
Mailing Address - Country:US
Mailing Address - Phone:661-228-0590
Mailing Address - Fax:661-843-6160
Practice Address - Street 1:20601 W VALLEY BLVD STE A104
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-8890
Practice Address - Country:US
Practice Address - Phone:661-228-0590
Practice Address - Fax:661-843-6160
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT132224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health