MEDICARE: DR. DEBRA FELGEN LANGER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY11217	CA
2	103TP2701X	Group Psychotherapy Psychologist	PSY11217	CA

General Provider Information

NPI Number	:	1740506872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA FELGEN LANGER PH.D.

Provider Business Mailing Address
First Line	:	3280 KELTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034
Country	:	US
Telephone Number	:	310-475-2406
Fax Number	:	310-475-2301

Provider Business Practice Location Address
First Line	:	3280 KELTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034
Country	:	US
Telephone Number	:	310-475-2406
Fax Number	:	310-475-2301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	04/14/2010

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