Provider Demographics
NPI:1023174646
Name:SALAZAR, LILIA PADILLA (PHD)
Entity type:Individual
Prefix:
First Name:LILIA
Middle Name:PADILLA
Last Name:SALAZAR
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 1:744 EMPIRE STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-372-5119
Mailing Address - Fax:707-759-4487
Practice Address - Street 1:744 EMPIRE STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-372-5119
Practice Address - Fax:707-759-4487
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14890103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist