Healthcare Provider Details

I. General information

NPI: 1467740373
Provider Name (Legal Business Name): MRS. ELIZABETH TANG-LIANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 16TH STREET
OAKLAND CA
94577
US

IV. Provider business mailing address

PO BOX 347235
SAN FRANCISCO CA
94134-7235
US

V. Phone/Fax

Practice location:
  • Phone: 415-508-7604
  • Fax:
Mailing address:
  • Phone: 415-508-7604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: