Healthcare Provider Details

I. General information

NPI: 1750751574
Provider Name (Legal Business Name): PEI YU PEGGY LIAO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2015
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 W CHAPMAN AVE STE 212
ORANGE CA
92868-2316
US

IV. Provider business mailing address

3220 MILLER ST
FLUSHING NY
11354-2739
US

V. Phone/Fax

Practice location:
  • Phone: 714-712-0711
  • Fax: 657-224-4781
Mailing address:
  • Phone: 718-838-8856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number095956
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number129677
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095956
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number095956-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: