Provider Demographics
NPI:1710500822
Name:LIU, KAYEE (RD/RDN)
Entity Type:Individual
Prefix:
First Name:KAYEE
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:RD/RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3753 CARLOS CT
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4811
Mailing Address - Country:US
Mailing Address - Phone:909-631-3821
Mailing Address - Fax:
Practice Address - Street 1:3753 CARLOS CT
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4811
Practice Address - Country:US
Practice Address - Phone:909-631-3821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered