Provider Demographics
NPI:1053035527
Name:DEAN, LILLIAN FAY
Entity type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:FAY
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:FAY
Other - Last Name:DUARTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RADT
Mailing Address - Street 1:3300 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3137
Mailing Address - Country:US
Mailing Address - Phone:661-868-7816
Mailing Address - Fax:
Practice Address - Street 1:3300 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3137
Practice Address - Country:US
Practice Address - Phone:661-868-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)