Provider Demographics
NPI:1285199182
Name:MOLAYEM, LILLIAN SARAH (MED, MA)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:SARAH
Last Name:MOLAYEM
Suffix:
Gender:
Credentials:MED, MA
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 25158
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-0158
Mailing Address - Country:US
Mailing Address - Phone:310-913-5459
Mailing Address - Fax:
Practice Address - Street 1:4221 WILSHIRE BLVD STE 320
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3559
Practice Address - Country:US
Practice Address - Phone:323-628-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AMFT153115106H00000X
1-18-33525103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst