Doctor Name: | ANDREW W LANGDON |
NPI Number: | 1053637967 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PSY26937 |
Business Practice Address: | 2155 Iron Point Rd Folsom, CA - 956308707 |
Business Phone Number: | 9168175636 |
Business Fax Number: | 9168175625 |
Mailing Address: | 2155 Iron Point Rd, FOLSOM |
State: | CA |
Postal Code: | 956308707 |
Phone Number: | 9168175636 |
Fax Number: | 9168175625 |
NPI Enumeration Date: | 04/16/2010 |
NPI Last Update Date: | 03/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | PSY26937 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |