Healthcare Provider Details

I. General information

NPI: 1407296262
Provider Name (Legal Business Name): KIMBERLY DAWN-MARIE LANG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23625 WR HOLMAN HWY
MONTEREY CA
93940-5902
US

IV. Provider business mailing address

23625 WR HOLMAN HWY
MONTEREY CA
93940-5902
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-5311
  • Fax: 831-625-4819
Mailing address:
  • Phone: 831-624-5311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number301850
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95013637
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0998397
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338050
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: