Healthcare Provider Details

I. General information

NPI: 1740544584
Provider Name (Legal Business Name): CHERYL LIANG M.A., CCC-SLP, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 MCGAW AVE STE 100
IRVINE CA
92614-5554
US

IV. Provider business mailing address

1570 E 17TH ST
SANTA ANA CA
92705-8511
US

V. Phone/Fax

Practice location:
  • Phone: 714-922-4453
  • Fax:
Mailing address:
  • Phone: 714-834-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-10-6932
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: