Healthcare Provider Details

I. General information

NPI: 1619841368
Provider Name (Legal Business Name): PRISCILLA LIU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22535 2ND ST
HAYWARD CA
94541-4111
US

IV. Provider business mailing address

3582 SOMERSET AVE
CASTRO VALLEY CA
94546-3357
US

V. Phone/Fax

Practice location:
  • Phone: 510-750-1654
  • Fax:
Mailing address:
  • Phone: 510-776-1513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: