Individual provider Active NPI

Rutong Martinez Liu, PSY.D.

  • Clinical Psychologist
  • El Paso, TX
National Provider Identifier
1821643107
Registry record updated Jan 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
40375 Issued in TX
Practice address
350 Revere St
El Paso, TX 79905-1633
Phone
(915) 564-6100
NPI assigned
Aug 5, 2019
Reactivated
May 9, 2025
Last updated
Jan 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 40375 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

350 Revere St
El Paso, TX 79905-1633

Mailing address

6521 Hoop St Unit a
El Paso, TX 79932-2565
Phone (915) 313-2772

Other names 1

  • Justin Liu Other name

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

State licenses

LicenseStateTypeSpecialty
40375TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Children's Society, Inc PastSince Aug 1, 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, 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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767484800000",
    "number": "1821643107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6521 HOOP ST UNIT A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799322565",
            "telephone_number": "915-313-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 REVERE ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051633",
            "telephone_number": "915-564-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "RUTONG",
        "middle_name": "MARTINEZ",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2026-01-04",
        "certification_date": "2026-01-04",
        "deactivation_date": "2024-12-31",
        "reactivation_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40375",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "LIU",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2026; 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.