Healthcare Provider Details

I. General information

NPI: 1881967404
Provider Name (Legal Business Name): LUCY Y LIU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YU LIU RN

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7547 DONEGAL DR
CUPERTINO CA
95014-5200
US

IV. Provider business mailing address

7547 DONEGAL DR
CUPERTINO CA
95014-5200
US

V. Phone/Fax

Practice location:
  • Phone: 408-591-4140
  • Fax:
Mailing address:
  • Phone: 408-591-4140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number512991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: