Provider Demographics
NPI:1831333244
Name:WILLIAMS, LILITH
Entity type:Individual
Prefix:MRS
First Name:LILITH
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 SCENIC AVE.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:562-491-5811
Mailing Address - Fax:562-435-8563
Practice Address - Street 1:415 W OCEAN BLVD
Practice Address - Street 2:100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4512
Practice Address - Country:US
Practice Address - Phone:562-491-5811
Practice Address - Fax:562-435-8563
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator