Individual provider Active NPI

Jacqueline Liu, PHARMD

  • Oncology Pharmacist
  • Walnut Creek, CA
National Provider Identifier
1164078903
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology PharmacistTaxonomy code 1835X0200X
License
78676 Issued in CA
Practice address
1425 South Main Street
Mob II, 2ND Floor
Walnut Creek, CA 94596
Phone
(925) 295-3353
NPI assigned
Aug 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Pharmacist 1835X0200X 78676 CA Primary

Addresses

Primary practice location

1425 South Main Street
Mob II, 2ND Floor
Walnut Creek, CA 94596

Mailing address

1425 S Main St FL 2
Walnut Creek, CA 94596-5318
Phone (925) 295-7370

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
78676CAMDOncology Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc PastSince Aug 18, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1164078903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S MAIN ST FL 2",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965318",
            "telephone_number": "925-295-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 SOUTH MAIN STREET",
            "address_2": "MOB II, 2ND FLOOR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94596",
            "telephone_number": "925-295-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "CA",
            "license": "78676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1425 South Main Street",
            "address_2": "MOB II, 2nd floor",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.