Provider Demographics
NPI:1417689878
Name:LIU, CATHERINE (MA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 PRIMO CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2545
Mailing Address - Country:US
Mailing Address - Phone:510-284-7635
Mailing Address - Fax:
Practice Address - Street 1:46280 BRIAR PL
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-6866
Practice Address - Country:US
Practice Address - Phone:510-490-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP30428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist