Healthcare Provider Details

I. General information

NPI: 1518199637
Provider Name (Legal Business Name): MS. JAMIE CHRISTINA LANGFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 5TH ST STE 212
SANTA ANA CA
92701-4522
US

IV. Provider business mailing address

5931 OLIVE AVE
LONG BEACH CA
90805-3516
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-2125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: