MEDICARE: SILVIA LIU PSY.D.

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	103T00000X	Psychologist	PSY94026324	CA
2	103TC0700X	Clinical Psychologist	PSY94026324	CA

General Provider Information

NPI Number	:	1508147034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SILVIA LIU PSY.D.

Provider Business Mailing Address
First Line	:	711 7TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90402-2711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12301 WILSHIRE BLVD STE 615
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1022
Country	:	US
Telephone Number	:	310-312-1015
Fax Number	:

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

Provider Enumeration Date	:	08/29/2011
Last Update Date	:	02/16/2024

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