Provider Demographics
NPI:1962170068
Name:LIU, YANG (MSW TRAINEE)
Entity type:Individual
Prefix:
First Name:YANG
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MSW TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 S SEPULVEDA BLVD APT 262
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6846
Mailing Address - Country:US
Mailing Address - Phone:626-251-3452
Mailing Address - Fax:
Practice Address - Street 1:520 S LA FAYETTE PARK PL FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1607
Practice Address - Country:US
Practice Address - Phone:213-252-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No175T00000XOther Service ProvidersPeer Specialist