Healthcare Provider Details

I. General information

NPI: 1679257950
Provider Name (Legal Business Name): WEIHUAN LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 STEWART DR # 151
SUNNYVALE CA
94085-4513
US

IV. Provider business mailing address

542 LAKESIDE DR STE 6
SUNNYVALE CA
94085-4005
US

V. Phone/Fax

Practice location:
  • Phone: 626-945-0966
  • Fax:
Mailing address:
  • Phone: 626-945-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number88545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: