Provider Demographics
NPI:1811762065
Name:HOWARD, LILIANA CONSEULO
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:CONSEULO
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15741 VILLA SIERRA RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-7655
Mailing Address - Country:US
Mailing Address - Phone:760-638-3682
Mailing Address - Fax:
Practice Address - Street 1:3365 TONOPAH ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3865
Practice Address - Country:US
Practice Address - Phone:760-583-9208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF5133818OtherDRIVER LICENSE