Healthcare Provider Details

I. General information

NPI: 1528181278
Provider Name (Legal Business Name): LIANN NICOLE HAGEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIANN NICOLE HANDEL MD

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S MAIN ST
WALNUT CREEK CA
94596-5318
US

IV. Provider business mailing address

644 CRAGMONT AVE
BERKELEY CA
94708-1343
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-5392
  • Fax:
Mailing address:
  • Phone: 310-703-3219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD61497562
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberMD61497562
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number99629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: