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General NPI Number Information
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NPI Number | 1962170068
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Entity Type | Individual
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Provider Name | YANG LIU MSW TRAINEE
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 520 S LA FAYETTE PARK PL FL 3
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City | LOS ANGELES
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State | CA
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Zip | 90057-1607
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Country | US
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Telephone | 213-252-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 3640 S SEPULVEDA BLVD APT 262
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City | LOS ANGELES
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State | CA
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Zip | 90034-6846
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Country | US
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Telephone | 626-251-3452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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