Healthcare Provider Details

I. General information

NPI: 1144806050
Provider Name (Legal Business Name): YUNTZU LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2423 HOOVER AVE
NATIONAL CITY CA
91950-6619
US

IV. Provider business mailing address

8380 HYDRA LN
SAN DIEGO CA
92126-1861
US

V. Phone/Fax

Practice location:
  • Phone: 619-795-9925
  • Fax:
Mailing address:
  • Phone: 949-394-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-75824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: