Provider Demographics
NPI:1790935989
Name:CHIANG, LILLIAN (PHD)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 BANCROFT WAY, MAIL CODE 4300
Mailing Address - Street 2:UNIVERSITY OF CALIFORNIA BERKELEY
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94720-4304
Mailing Address - Country:US
Mailing Address - Phone:510-642-2709
Mailing Address - Fax:510-642-2368
Practice Address - Street 1:2222 BANCROFT WAY SPC 4300
Practice Address - Street 2:UNIVERSITY OF CALIFORNIA BERKELEY
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-4300
Practice Address - Country:US
Practice Address - Phone:510-642-2709
Practice Address - Fax:510-642-2368
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling