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General NPI Number Information
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NPI Number | 1053637967
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Entity Type | Individual
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Provider Name | ANDREW W LANGDON PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 2155 IRON POINT RD
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City | FOLSOM
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State | CA
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Zip | 95630-8707
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Country | US
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Telephone | 916-817-5636
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Fax | 916-817-5625
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Provider Business Mailing Address
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Address Line | 2155 IRON POINT RD
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City | FOLSOM
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State | CA
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Zip | 95630-8707
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Country | US
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Telephone | 916-817-5636
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Fax | 916-817-5625
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY26937
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License Number State | CA
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