Healthcare Provider Details

I. General information

NPI: 1407464357
Provider Name (Legal Business Name): ANCHOR HEALTH PARTNER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 W INDIAN SCHOOL RD STE 131
PHOENIX AZ
85037-2388
US

IV. Provider business mailing address

9150 W INDIAN SCHOOL RD STE 131
PHOENIX AZ
85037-2388
US

V. Phone/Fax

Practice location:
  • Phone: 310-893-4455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANNA GAN LIU
Title or Position: MANAGING DIRECTOR
Credential: LCSW
Phone: 310-893-4455