Organization Active NPI

Kristin a. Liang, PH.D. Professional Psychological Services Inc

  • Clinical Psychologist
  • Covina, CA
National Provider Identifier
1669863056
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22902 Issued in CA
Legal business name
KRISTIN A. LIANG, PH.D. PROFESSIONAL PSYCHOLOGICAL SERVICES INC
Practice address
500 W Badillo St
Covina, CA 91722-3762
Phone
(626) 339-0288
Fax
(626) 339-2248
NPI assigned
Feb 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Authorized official

Name
Kristin A Liang, PH.D.NPI 1578796397
Title
Psychologist
Phone
(626) 339-0288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY22902 CA Primary

Addresses

Primary practice location

500 W Badillo St
Covina, CA 91722-3762

Mailing address

500 W Badillo St
Covina, CA 91722-3762
Phone (626) 339-0288

Other identifiers 1

IdentifierTypeStateIssuer
PSY229020MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150622001510 CA Part B Supplier - Clinic/Group Practice 1759692403 Receives reassigned benefits from 1 practitioner
Practice locations: Covina, CA

National Provider Directory

National Provider Directory

Locations

969 S Village Oaks Dr
Ste 102
Covina, CA 91724
Phone (626) 722-8118

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423267200000",
    "number": "1669863056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223762",
            "telephone_number": "626-339-0288",
            "fax_number": "626-339-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223762",
            "telephone_number": "626-339-0288",
            "fax_number": "626-339-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN A. LIANG, PH.D. PROFESSIONAL PSYCHOLOGICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-07",
        "last_updated": "2015-02-07",
        "status": "A",
        "authorized_official_last_name": "LIANG",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "626-339-0288",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY229020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.