Individual
LILY RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
629 CAMINO DE LOS MARES STE 207A, SAN CLEMENTE, CA 92673-2832
(714) 345-5200
Mailing address
629 CAMINO DE LOS MARES STE 207A, SAN CLEMENTE, CA 92673-2832
(714) 345-5200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/15/2017
Last updated
10/21/2020
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