Healthcare Provider Details

I. General information

NPI: 1982080313
Provider Name (Legal Business Name): CHEN YU LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHEN YU LIU

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 N PACER CT
WALNUT CA
91789-1470
US

IV. Provider business mailing address

648 N PACER CT
WALNUT CA
91789-1470
US

V. Phone/Fax

Practice location:
  • Phone: 909-859-5192
  • Fax:
Mailing address:
  • Phone: 909-859-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT41483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: