Provider Demographics
NPI:1609827443
Name:LIU, SHWUJING JESSICA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHWUJING
Middle Name:JESSICA
Last Name:LIU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:13768 ROSWELL AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1408
Mailing Address - Country:US
Mailing Address - Phone:213-252-2100
Mailing Address - Fax:213-383-3146
Practice Address - Street 1:605 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1483
Practice Address - Country:US
Practice Address - Phone:213-553-1850
Practice Address - Fax:213-553-1864
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW20897Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER