Provider Demographics
NPI:1649594185
Name:DEVASHER, LILA KATHLEEN (LMFT)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:KATHLEEN
Last Name:DEVASHER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910226
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92191-0226
Mailing Address - Country:US
Mailing Address - Phone:858-729-0692
Mailing Address - Fax:858-638-1576
Practice Address - Street 1:6540 LUSK BLVD
Practice Address - Street 2:SUITE C-135
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2767
Practice Address - Country:US
Practice Address - Phone:858-729-0692
Practice Address - Fax:858-638-1576
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC9296106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist