Healthcare Provider Details

I. General information

NPI: 1427844489
Provider Name (Legal Business Name): JOYCE LIU
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 DOVE ST STE 140
NEWPORT BEACH CA
92660-2837
US

IV. Provider business mailing address

1151 DOVE ST STE 140
NEWPORT BEACH CA
92660-2837
US

V. Phone/Fax

Practice location:
  • Phone: 657-294-5113
  • Fax: 657-294-5114
Mailing address:
  • Phone: 657-294-5113
  • Fax: 657-294-5114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: