Provider Demographics
NPI:1043534035
Name:LIANG, YA-SHU (PHD)
Entity Type:Individual
Prefix:
First Name:YA-SHU
Middle Name:
Last Name:LIANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6830
Mailing Address - Street 2:CAPS-CALIFORNIA STATE UNIVERSITY, FULLERTON
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92834-6830
Mailing Address - Country:US
Mailing Address - Phone:714-494-7479
Mailing Address - Fax:
Practice Address - Street 1:17632 IRVINE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3148
Practice Address - Country:US
Practice Address - Phone:714-494-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22323103TC1900X
NYPSY 017443103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling