Healthcare Provider Details

I. General information

NPI: 1093550204
Provider Name (Legal Business Name): ERIK CHARLES LANGSLET
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20377 SW ACACIA ST STE 110
NEWPORT BEACH CA
92660-0781
US

IV. Provider business mailing address

20377 SW ACACIA ST STE 110
NEWPORT BEACH CA
92660-0781
US

V. Phone/Fax

Practice location:
  • Phone: 888-717-9355
  • Fax:
Mailing address:
  • Phone: 949-239-1354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW119305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: