Doctor Name: | JESSICA JEANNE LANG |
NPI Number: | 1629200803 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 333 Sunset Ave # Dr188 Suisun City, CA - 945852003 |
Business Phone Number: | 7144959589 |
Business Fax Number: | |
Mailing Address: | 1333 Kains Ave, BERKELEY |
State: | CA |
Postal Code: | 947021015 |
Phone Number: | 7144959589 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2009 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |