MEDICARE: DR. ARIEL JANNA LANG PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist	PSY1539	CA
2	103TA0700X	Adult Development & Aging Psychologist	PSY16539	CA
3	103TB0200X	Cognitive & Behavioral Psychologist	PSY16539	CA
4	103TC0700X	Clinical Psychologist	PSY16539	CA
5	103TH0100X	Health Service Psychologist	PSY16539	CA
6	103T00000X	Psychologist	PSY16539	CA
7	103TP2701X	Group Psychotherapy Psychologist	PSY16539	CA

General Provider Information

NPI Number	:	1629002092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARIEL JANNA LANG PH.D.

Provider Business Mailing Address
First Line	:	8810 RIO SAN DIEGO DR # MC116A4Z
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1622
Country	:	US
Telephone Number	:	619-400-5173
Fax Number	:	619-400-5171

Provider Business Practice Location Address
First Line	:	8810 RIO SAN DIEGO DR # MC116A4Z
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1622
Country	:	US
Telephone Number	:	619-400-5173
Fax Number	:	619-400-5171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/11/2025

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