Provider Demographics
NPI:1417568569
Name:LIAO, CHING-PING
Entity Type:Individual
Prefix:MR
First Name:CHING-PING
Middle Name:
Last Name:LIAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 MARSHALL RD APT 17
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-5764
Mailing Address - Country:US
Mailing Address - Phone:412-326-7877
Mailing Address - Fax:
Practice Address - Street 1:2490 HILBORN RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1072
Practice Address - Country:US
Practice Address - Phone:412-326-7877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT15804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist