Mary L Lilly, PHD RN MS MSN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

760860 Issued in TX

Practice address

4715 Viewridge Ave
San Diego, CA 92123-1658

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

Aug 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science, Master of Science - Nursing, Doctor of Philosophy, Registered Nurse

State licenses

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496361600000",
    "number": "1821221920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 NORTH PIEDRAS",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79930",
            "telephone_number": "915-564-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 VIEWRIDGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231658",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Prof.",
        "credential": "PHD RN MS MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2017-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN169742",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IN",
            "license": "70000096A",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "760860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Matthew Lilley
• Dustin Michael Lillie, M.D.
• Laura Lilly Faherty, RBT
• Abigail Lilly
• Elizabeth Anne Lilly, OTR/L
• Lilos Tender Senior Care Inc
• Joyce Beth Lilya, LCSW
• Makenna Brianne Lilya, AMFT
• Albert Y Lim, D.O.
• Antony Y Lim, L.AC.

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; 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.