Healthcare Provider Details

I. General information

NPI: 1497301238
Provider Name (Legal Business Name): MS. XING LIAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 KINGSTON PL
WALNUT CREEK CA
94597-3130
US

IV. Provider business mailing address

7 KINGSTON PL
WALNUT CREEK CA
94597-3130
US

V. Phone/Fax

Practice location:
  • Phone: 925-478-5603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-57366
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: