Healthcare Provider Details

I. General information

NPI: 1447154588
Provider Name (Legal Business Name): JIANDI LIANG ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JIAN LIANG ASW

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 ASHBY AVE
BERKELEY CA
94705-2200
US

IV. Provider business mailing address

2615 ASHBY AVE
BERKELEY CA
94705-2200
US

V. Phone/Fax

Practice location:
  • Phone: 510-210-3640
  • Fax:
Mailing address:
  • Phone: 510-210-3640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number78G28815190
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: