Basic Information
| Provider Information | |||||||||
| NPI: | 1194029249 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANGHANS | ||||||||
| FirstName: | KELSEY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13800 PARKCENTER LN APT 308 | ||||||||
| Address2: | |||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927828510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145852621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 131 W MIDWAY DR | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928056507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145177107 | ||||||||
| FaxNumber: | 7149561990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2011 | ||||||||
| LastUpdateDate: | 01/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.