Individual provider Active NPI

Carole Ann Liu

  • General Practice Registered Nurse
  • Magalia, CA
National Provider Identifier
1104117530
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
659398 Issued in CA
Practice address
6079 Mason CT
Magalia, CA 95954-9678
Phone
(530) 520-7948
Fax
(530) 873-6179
NPI assigned
Apr 19, 2011
Last updated
Apr 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Continuing Education/Staff Development Registered Nurse 163WC1600X 659398 CA
Cardiac Rehabilitation Registered Nurse 163WC3500X 659398 CA
Diabetes Educator Registered Nurse 163WD0400X 659398 CA
General Practice Registered Nurse 163WG0000X 659398 CA Primary
Infection Control Registered Nurse 163WI0600X 659398 CA
Rehabilitation Registered Nurse 163WR0400X 659398 CA
Wound Care Registered Nurse 163WW0000X 659398 CA

Addresses

Primary practice location

6079 Mason CT
Magalia, CA 95954-9678

Mailing address

6079 Mason CT
Magalia, CA 95954-9678
Phone (530) 520-7948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
659398CAMDWound Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1104117530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6079 MASON CT",
            "city": "MAGALIA",
            "state": "CA",
            "postal_code": "959549678",
            "telephone_number": "530-520-7948",
            "fax_number": "530-873-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6079 MASON CT",
            "city": "MAGALIA",
            "state": "CA",
            "postal_code": "959549678",
            "telephone_number": "530-520-7948",
            "fax_number": "530-873-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "CAROLE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "CA",
            "license": "659398",
            "primary": false
        },
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "CA",
            "license": "659398",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "659398",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "659398",
            "primary": true
        },
        {
            "code": "163WI0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infection Control",
            "state": "CA",
            "license": "659398",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "CA",
            "license": "659398",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "CA",
            "license": "659398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.