Healthcare Provider Details

I. General information

NPI: 1033428867
Provider Name (Legal Business Name): HENG-HSIAN NANCY LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. NANCY H LIU

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 BERKELEY WAY # MC1650
BERKELEY CA
94720-2502
US

IV. Provider business mailing address

2121 BERKELEY WAY # MC1650
BERKELEY CA
94720-2502
US

V. Phone/Fax

Practice location:
  • Phone: 510-643-8850
  • Fax:
Mailing address:
  • Phone: 510-643-8850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number26859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: