Lily Reve Markle

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

145607 Issued in CA

Practice address

680 Langsdorf Dr Ste 200
Fullerton, CA 92831-3702

Phone

(714) 871-9264

Fax

(714) 871-5032

NPI assigned

Jan 9, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child Guidance Center, Inc.

  • Community/Behavioral Health Agency
  • Fullerton, CA
  • NPI 1003936311
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1558075127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR STE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313702",
            "telephone_number": "714-871-9264",
            "fax_number": "714-871-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKLE",
        "first_name": "LILY",
        "middle_name": "REVE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Marino, D.O.
• Marites Perez Lunastar, Dental Practice Inc
• Mark M. Song, M.D., Inc.
• Kasey Markell, MS, ATC
• Kelly Markham
• Dominick Isaiah Marmolejo I
• Adriana Marquez-Gallegos
• Eric Ricardo Marquez
• Caitlyn Michelle Marr
• Sali Marroki

• Marriage & Family Therapist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.