Provider Demographics
NPI:1659866416
Name:CHANG, LILLIAN WEI (PMHNP)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:WEI
Last Name:CHANG
Suffix:
Gender:F
Credentials:PMHNP
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Mailing Address - Street 1:13555 W MCDOWELL RD
Mailing Address - Street 2:STE 205
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2626
Mailing Address - Country:US
Mailing Address - Phone:623-295-1190
Mailing Address - Fax:602-429-8595
Practice Address - Street 1:2715 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1106
Practice Address - Country:US
Practice Address - Phone:602-808-2800
Practice Address - Fax:602-808-2799
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP11303363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health