MEDICARE: KAIDI LIU MARRIAGE FAMILY THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1023972395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAIDI LIU MARRIAGE FAMILY THERAPY

Provider Business Mailing Address
First Line	:	516 PENNSFIELD PL STE 208
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-5530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 PENNSFIELD PL STE 208
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-5530
Country	:	US
Telephone Number	:	805-694-0251
Fax Number	:

Authorized Official
Title or Position	:	LMFT
Name	:	KAIDI LIU
Credential	:	LMFT
Telephone Number	:	818-606-9079

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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