Individual provider Active NPI

Haizhu Pearl Liu, M.D.

  • Psychiatry Physician
  • Atascadero, CA
National Provider Identifier
1033369491
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C178973 Issued in CA
Practice address
10333 El Camino Real
Atascadero, CA 93422-5808
Phone
(805) 468-2000
NPI assigned
Sep 23, 2008
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 240899 NY
Psychiatry Physician 2084P0800X C178973 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 240899 NY

Addresses

Primary practice location

10333 El Camino Real
Atascadero, CA 93422-5808

Mailing address

620 Madison St
Syracuse, NY 13210-2319
Phone (315) 426-3600

Other practice location 1

1003 Park St
Ogdensburg, NY 13669-3911
Phone (315) 713-9090

Other practice location 2

650 State Street
Watertown, NY 13601-2839
Phone (315) 755-1251

Other practice location 3

620 Madison St
Syracuse, NY 13210-2319
Phone (315) 426-3600

Other identifiers 1

IdentifierTypeStateIssuer
03142385MedicaidNY

Other names 1

  • Dr. Haizhu Pearl Wang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100216000056 NY Practitioner - Psychiatry 0547304511 Reassigns benefits to 3 organizations
I20250303002618 CA Practitioner - Psychiatry 0547304511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizen Advocates, IncGroup PAC ID 0648241976, 50 clinicians

Practice addresses (Care Compare)

15 Francis St
Malone, NY 12953-1807
Phone (518) 483-1251

650 State St
Watertown, NY 13601-2839
Phone (315) 755-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C178973CAMDPsychiatry Physician
240899NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Soldiers & Sailors Memorial Hospital CurrentSince Apr 6, 2019 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Feb 3, 2025 Accepting new patients
St. Joseph's Pathology, PC Current Accepting new patients
Citizen Advocates, Inc CurrentSince Mar 6, 2023 Accepting new patients
Soldiers & Sailors Memorial Hospital CurrentSince Apr 6, 2019 Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

15 Francis St
Malone, NY 12953
Phone (518) 483-7801

1003 Park St
Ogdensburg, NY 13669
Phone (315) 713-9090

418 N Main St
Penn Yan, NY 14527
Phone (315) 531-2000

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

650 State St
Watertown, NY 13601
Phone (315) 755-1251

Interoperability endpoints

  • Direct secure messaging: hliu2388360@direct.trinity-health.org
  • Direct secure messaging: lhz22202@hiemail.healtheconnections.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1033369491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MADISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102319",
            "telephone_number": "315-426-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225808",
            "telephone_number": "805-468-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Park St",
            "address_purpose": "LOCATION",
            "city": "Ogdensburg",
            "state": "NY",
            "postal_code": "136693911",
            "country_code": "US",
            "telephone_number": "315-713-9090",
            "fax_number": "315-713-9330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 State Street",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136012839",
            "country_code": "US",
            "telephone_number": "315-755-1251",
            "fax_number": "315-291-6601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Madison St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102319",
            "country_code": "US",
            "telephone_number": "315-426-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "HAIZHU",
        "middle_name": "PEARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "240899",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C178973",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "240899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03142385",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAIZHU",
            "last_name": "WANG",
            "middle_name": "PEARL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atascadero, CA

Sources for this page

Verify at the official NPI Registry.