Provider Demographics
NPI:1871919324
Name:FLORES, LILLY ALEJANDRA (BCBA)
Entity type:Individual
Prefix:
First Name:LILLY
Middle Name:ALEJANDRA
Last Name:FLORES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LILLY
Other - Middle Name:ALEJANDRA
Other - Last Name:FLORES-FIUMARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:22930 CANYON VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-9148
Mailing Address - Country:US
Mailing Address - Phone:626-757-4940
Mailing Address - Fax:951-254-9737
Practice Address - Street 1:22930 CANYON VIEW DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-9148
Practice Address - Country:US
Practice Address - Phone:626-757-4940
Practice Address - Fax:951-254-9737
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7080103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst