Provider Demographics
NPI:1902820905
Name:GOLDFARB, LILLIAN JANINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:JANINE
Last Name:GOLDFARB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 CALLE VALLE VIS
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1938
Mailing Address - Country:US
Mailing Address - Phone:805-490-0455
Mailing Address - Fax:805-499-2433
Practice Address - Street 1:30101 AGOURA CT STE 240
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-5901
Practice Address - Country:US
Practice Address - Phone:805-490-0455
Practice Address - Fax:805-499-2433
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS177201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical