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General NPI Number Information
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NPI Number | 1336284553
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Entity Type | Organization
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Legal Business Name | ANGELA LIU
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 200 E DEL MAR BLVD STE 208
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City | PASADENA
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State | CA
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Zip | 91105-2552
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Country | US
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Telephone | 626-200-8986
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E DEL MAR BLVD STE 208
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City | PASADENA
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State | CA
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Zip | 91105-2552
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Country | US
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Telephone | 626-200-8986
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ANGELA LIU
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Credential | PSY.D.
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Telephone | 626-200-8986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | PSY20303
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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