Provider Demographics
NPI:1285125088
Name:WOOD, LILIANA MONICA (PT)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:MONICA
Last Name:WOOD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7379
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-7379
Mailing Address - Country:US
Mailing Address - Phone:714-281-0169
Mailing Address - Fax:714-281-2238
Practice Address - Street 1:30025 ALICIA PKWY
Practice Address - Street 2:ST. G-262
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677
Practice Address - Country:US
Practice Address - Phone:714-281-0169
Practice Address - Fax:714-812-2382
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics