Individual provider Active NPI

Kristine Liu

  • Behavior Analyst
  • Canoga Park, CA
National Provider Identifier
1194224667
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
21201 Victory Blvd Ste 205
Canoga Park, CA 91303-4056
Phone
(888) 428-3223
Fax
(323) 866-1881
NPI assigned
Feb 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

21201 Victory Blvd Ste 205
Canoga Park, CA 91303-4056

Mailing address

4221 Wilshire Blvd Ste 300a
Los Angeles, CA 90010-3537
Phone (888) 428-3223

Other practice location 1

17200 Ventura Blvd Ste 125
Encino, CA 91316-4030
Phone (818) 501-0822

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

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Effective Behavioral Interventions Behavior Analyst Past 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": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1194224667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 300A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103537",
            "telephone_number": "888-428-3223",
            "fax_number": "323-866-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21201 VICTORY BLVD STE 205",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913034056",
            "telephone_number": "888-428-3223",
            "fax_number": "323-866-1881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17200 Ventura Blvd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "913164030",
            "country_code": "US",
            "telephone_number": "818-501-0822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.