Healthcare Provider Details

I. General information

NPI: 1952274656
Provider Name (Legal Business Name): YADI LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 SAN RAMON VALLEY BLVD UNIT 214
SAN RAMON CA
94583-1671
US

IV. Provider business mailing address

169 WAVERLY ST
SUNNYVALE CA
94086-6022
US

V. Phone/Fax

Practice location:
  • Phone: 925-659-1260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT308210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: