Provider Demographics
NPI:1689936007
Name:LILIENSTEIN, ALIA ANNETTE CREASEY (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALIA
Middle Name:ANNETTE CREASEY
Last Name:LILIENSTEIN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:ALIA
Other - Middle Name:ANNETTE
Other - Last Name:CREASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1403 STANNAGE AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1031
Mailing Address - Country:US
Mailing Address - Phone:510-708-4622
Mailing Address - Fax:
Practice Address - Street 1:1403 STANNAGE AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-1031
Practice Address - Country:US
Practice Address - Phone:510-708-4622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine