Provider Demographics
NPI:1215534052
Name:LIANG, JEFFREY (DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:LIANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:3736 FALLON RD # 650
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7400
Mailing Address - Country:US
Mailing Address - Phone:925-699-2725
Mailing Address - Fax:
Practice Address - Street 1:4626 WILLOW RD
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8517
Practice Address - Country:US
Practice Address - Phone:866-623-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2022-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist