Individual provider Active NPI

Silvia Liu, PSY.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1508147034
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY94026324 Issued in CA
Practice address
12301 Wilshire Blvd Ste 615
Los Angeles, CA 90025-1022
Phone
(310) 312-1015
NPI assigned
Aug 29, 2011
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY94026324 CA
Clinical Psychologist 103TC0700X PSY94026324 CA Primary

Addresses

Primary practice location

12301 Wilshire Blvd Ste 615
Los Angeles, CA 90025-1022

Mailing address

711 7TH St
Santa Monica, CA 90402-2711

Other practice location 1

2810 E Del Mar Blvd Ste 10B
Pasadena, CA 91107-4323
Phone (310) 698-2031

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230504001398 CA Practitioner - Clinical Psychologist 0345605945 Reassigns benefits to 1 organization
Practice locations: Pasadena, CA; Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2810 E del Mar Blvd
Suite 10B
Pasadena, CA 91107-4323
Phone (626) 346-9960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY94026324CAMDPsychologist
34058CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Bio-Behavioral Science Medical Corporation CurrentSince Feb 18, 2024 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 615
Los Angeles, CA 90025
Phone (310) 312-1013

Organizations & group practices 2

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": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1508147034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 7TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 615",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251022",
            "telephone_number": "310-312-1015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 E Del Mar Blvd Ste 10B",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911074323",
            "country_code": "US",
            "telephone_number": "310-698-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "SILVIA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2024-02-16",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY94026324",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY94026324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.