Active NPI
Shirley H. Liu, M.D.
- Child & Adolescent Psychiatry Physician
- San Jose, CA
National Provider Identifier
1902077035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A95004
- Practice address
- 1340 Tully Rd Ste 301
San Jose, CA 95122-3055 - Phone
- (650) 268-4250
- NPI assigned
- Mar 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 257424 | NY | |
| Psychiatry Physician | 2084P0800X | A95004 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 235957 | MA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | A95004 | CA | Primary |
Addresses
Primary practice location
1340 Tully Rd Ste 301
San Jose, CA 95122-3055
Mailing address
1340 Tully Rd Ste 301
San Jose, CA 95122-3055
Phone (650) 268-4250
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00356318 | Medicaid | NY | |
| 331817 | Other | MEDICARE PROVIDER NUMBER |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A95004 | CA | MD | Psychiatry Physician |
| 235957 | MA | MD | Child & Adolescent Psychiatry Physician |
| 257424 | NY | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469923200000",
"number": "1902077035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 TULLY RD STE 301",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951223055",
"telephone_number": "650-268-4250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 TULLY RD STE 301",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951223055",
"telephone_number": "650-268-4250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "SHIRLEY",
"middle_name": "H.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-17",
"last_updated": "2016-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "257424",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A95004",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "235957",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A95004",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00356318",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "331817",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.