Lillian Phan, M.S., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-10-7132 Issued in CA

Practice address

11037 Warner Ave # 339
Fountain Valley, CA 92708-4007

Phone

(714) 848-8319

NPI assigned

Sep 6, 2012

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

Practice roles

Locations

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

• Milestones Behavioral Care LLC

  • Behavior Analyst
  • Huntington Beach, CA
  • NPI 1952962326
  NPD
• Footprints Behavioral Interventions, Inc.

  dba Footprints Behavioral Interventions

  • Early Intervention Provider Agency
  • Santa Ana, CA
  • NPI 1780978858
  NPD (past)

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1811246721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE # 339",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "714-848-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE # 339",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "714-848-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LILLIAN",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-10-7132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Han T Phan
• Huan Phan
• Ivy Phan
• Justin Phan
• Leah Phan, D.O.
• Linh Ngockhanh Phan
• Michael Khai Phan, DC
• Pauline Lee Phan, D.D.S.
• Tiffany Phan, FNP
• Pharmacore, Inc. (Trinity Mission Pharmacy)

• Behavior Analyst in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.