MEDICARE: ANGELA LIU PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY20303	CA

General Provider Information

NPI Number	:	1871763615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA LIU PSY.D.

Provider Business Mailing Address
First Line	:	200 E DEL MAR BLVD STE 208
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2552
Country	:	US
Telephone Number	:	626-200-8986
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E DEL MAR BLVD STE 208
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2552
Country	:	US
Telephone Number	:	626-200-8986
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	03/07/2008

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