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General NPI Number Information
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NPI Number | 1427857788
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Entity Type | Individual
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Provider Name | DOROTHY PANG PH.D., LP, NCSP
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 31 CLOUD BROOK DR
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City | MISSOURI CITY
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State | TX
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Zip | 77459-1418
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Country | US
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Telephone | 650-495-0115
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Fax |
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Provider Business Mailing Address
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Address Line | 3790 EL CAMINO REAL # 1343
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City | PALO ALTO
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State | CA
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Zip | 94306-3314
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Country | US
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Telephone |
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 39898
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 72425
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 34486
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License Number State | CA
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