MEDICARE: HENG-HSIAN NANCY LIU

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	390200000X	Student in an Organized Health Care Education/Training Program
2	103TC0700X	Clinical Psychologist	26859	CA

General Provider Information

NPI Number	:	1033428867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENG-HSIAN NANCY LIU

Provider Business Mailing Address
First Line	:	2121 BERKELEY WAY # MC1650
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94720-2502
Country	:	US
Telephone Number	:	510-643-8850
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 BERKELEY WAY # MC1650
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94720-2502
Country	:	US
Telephone Number	:	510-643-8850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2010
Last Update Date	:	01/12/2022

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Directions to “ HENG-HSIAN NANCY LIU ” Practice Location

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