Provider Demographics
NPI:1396217220
Name:LIU, DANIELLE K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:K
Last Name:LIU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1212 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2260
Mailing Address - Country:US
Mailing Address - Phone:831-422-7777
Mailing Address - Fax:831-422-0136
Practice Address - Street 1:1212 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2260
Practice Address - Country:US
Practice Address - Phone:831-422-7777
Practice Address - Fax:831-422-0136
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA57083363A00000X
VA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant