Provider Demographics
NPI:1811139884
Name:LOUIE, LILA (NP, LCSW)
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:
Last Name:LOUIE
Suffix:
Gender:F
Credentials:NP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 GOLDEN GATE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3810
Mailing Address - Country:US
Mailing Address - Phone:415-673-5700
Mailing Address - Fax:415-292-7140
Practice Address - Street 1:134 GOLDEN GATE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3810
Practice Address - Country:US
Practice Address - Phone:415-673-5700
Practice Address - Fax:415-292-7140
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS174341041C0700X
CA23360363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA17434OtherLCSW
CA23360OtherNP