Active NPI
Donald Amos Lilley, LMFT
- Contractor
- Modesto, CA
National Provider Identifier
1588922140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- LMFT 19577
- Practice address
- 1800 Tully Rd
Suite F
Modesto, CA 95350-2946 - Phone
- (209) 576-1750
- NPI assigned
- May 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | LMFT 19577 | CA | Primary |
Addresses
Primary practice location
1800 Tully Rd
Suite F
Modesto, CA 95350-2946
Mailing address
12414 Mills St
Groveland, CA 95321-9322
Phone (209) 962-6540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT 19577 | CA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335830400000",
"number": "1588922140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12414 MILLS ST",
"city": "GROVELAND",
"state": "CA",
"postal_code": "953219322",
"telephone_number": "209-962-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 TULLY RD",
"address_2": "SUITE F",
"city": "MODESTO",
"state": "CA",
"postal_code": "953502946",
"telephone_number": "209-576-1750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLEY",
"first_name": "DONALD",
"middle_name": "AMOS",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-01",
"last_updated": "2012-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "LMFT 19577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.