Provider Demographics
NPI:1295581817
Name:LIU, MICHELLE HSIAOYEN (NP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HSIAOYEN
Last Name:LIU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WINTHROP DR
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1047
Mailing Address - Country:US
Mailing Address - Phone:626-382-6090
Mailing Address - Fax:
Practice Address - Street 1:420 WINTHROP DR
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-1047
Practice Address - Country:US
Practice Address - Phone:626-382-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029395363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care