Healthcare Provider Details

I. General information

NPI: 1154156016
Provider Name (Legal Business Name): WENYUN LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 MORELLA AVE UNIT 8
VALLEY VILLAGE CA
91607-2287
US

IV. Provider business mailing address

5401 MORELLA AVE UNIT 8
VALLEY VILLAGE CA
91607-2287
US

V. Phone/Fax

Practice location:
  • Phone: 310-621-3642
  • Fax:
Mailing address:
  • Phone: 310-621-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: