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General NPI Number Information
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NPI Number | 1629944533
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Entity Type | Individual
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Provider Name | JEFF LOUIS LANE LPT
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Gender | Male
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 7959 ORANGE AVE
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City | FAIR OAKS
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State | CA
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Zip | 95628-5916
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Country | US
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Telephone | 916-485-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 340 LANFRANCO CIR
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City | SACRAMENTO
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State | CA
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Zip | 95835-2068
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Country | US
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Telephone | 916-470-8062
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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 | 167G00000X
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Taxonomy Name | Licensed Psychiatric Technician
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License Number | PT40875
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License Number State | CA
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