Provider Demographics
NPI:1912597782
Name:LIU, KAREN P (MFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:P
Last Name:LIU
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 PARK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5835
Mailing Address - Country:US
Mailing Address - Phone:415-484-5470
Mailing Address - Fax:
Practice Address - Street 1:119 PARK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5835
Practice Address - Country:US
Practice Address - Phone:415-484-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111188106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA111188OtherBOARD OF BEHAVIORAL SCIENCES