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NPI Code Detail

MEDICARE: CHERYL LIANG M.A., CCC-SLP, BCBA

MEDICARE: CHERYL LIANG M.A., CCC-SLP, BCBA
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
1103K00000XBehavior Analyst1-10-6932CA
2235Z00000XSpeech-Language Pathologist17359CA

General Provider Information

NPI Number : 1740544584
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL LIANG M.A., CCC-SLP, BCBA
Provider Business Mailing Address
First Line : 1570 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-8511
Country : US
Telephone Number : 714-834-1111
Fax Number :
Provider Business Practice Location Address
First Line : 1063 MCGAW AVE STE 100
Second Line :
City : IRVINE
State : CA
Zip : 92614-5554
Country : US
Telephone Number : 714-922-4453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2012
Last Update Date : 02/02/2021

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