Individual provider Active NPI

Lucy Pei-Ju Liao, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1194973990
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A 102540 Issued in CA
Practice address
520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607
Phone
(213) 252-2100
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A 102540 CA Primary

Addresses

Primary practice location

520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 825-0326

Other practice location 1

760 Westwood Plz
Ste C8-222
Los Angeles, CA 90024-5055
Phone (310) 825-0326

Other practice location 2

1635 W Main St Ste 100
Alhambra, CA 91801-1951
Phone (626) 248-1800

Other identifiers 1

IdentifierTypeStateIssuer
00A102540MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000196 CA Practitioner - Psychiatry 9638223167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Special Service for Groups IncGroup PAC ID 2769396886, 61 clinicians
San Fernando Valley Community Mental Health CenterGroup PAC ID 1456332998, 2 clinicians

Practice addresses (Care Compare)

1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone (213) 483-3000

14545 Sherman Cir
Van Nuys, CA 91405-3087
Phone (818) 901-4854

1635 W Main St
Suite 100
Alhambra, CA 91801-1951
Phone (626) 248-1800

16650 Sherman Way
Van Nuys, CA 91406-3782
Phone (818) 904-3946

520 S Lafayette Park PL
FL 3
Los Angeles, CA 90057-5400
Phone (213) 252-2100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. CurrentSince Jul 1, 2009 Accepting new patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Jul 1, 2009 Accepting new patients
San Fernando Valley Community Mental Health Center Psychiatry CurrentSince Dec 19, 2011 Accepting new patients

Locations

1635 W Main St
Ste 100
Alhambra, CA 91801
Phone (626) 248-1800

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

16650 Sherman Way
Van Nuys, CA 91406
Phone (818) 785-0103

14545 Sherman Cir
Van Nuys, CA 91405
Phone (818) 901-4854

16360 Roscoe Blvd
Ste 200
Van Nuys, CA 91406
Phone (818) 815-7951

Organizations & group practices 4

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1194973990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571607",
            "telephone_number": "213-252-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Westwood Plz",
            "address_2": "Ste C8-222",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900245055",
            "country_code": "US",
            "telephone_number": "310-825-0326",
            "fax_number": "310-825-0340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1635 W Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918011951",
            "country_code": "US",
            "telephone_number": "626-248-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIAO",
        "first_name": "LUCY",
        "middle_name": "PEI-JU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A 102540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A102540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.