MEDICARE: DR. JOHN G LANG 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	318	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760582464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN G LANG PH.D.

Provider Business Mailing Address
First Line	:	721 BOND ST
Second Line	:
City	:	ESPANOLA
State	:	NM
Zip	:	87532-2729
Country	:	US
Telephone Number	:	505-753-5811
Fax Number	:	505-747-3210

Provider Business Practice Location Address
First Line	:	721 BOND ST
Second Line	:
City	:	ESPANOLA
State	:	NM
Zip	:	87532-2729
Country	:	US
Telephone Number	:	505-753-5811
Fax Number	:	505-747-3210

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	01/28/2013

Similar Medicare Providers

1770576134 — DR. BRENT J. VAN ANDEL M.D.
Practice Location Address:

711 BOND ST , EL CENTRO FAMILY HEALTH BOND CLINIC
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax: 505-747-1004

1700879160 — MS. XOCHITL ROMERO PA-C
Practice Location Address:

711 BOND ST
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax: 505-747-1004

1871799858 — WELLNESS CLINICAL SERVICES INC.
Practice Location Address:

721 BOND ST
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-5811
Practice Fax: 505-747-3210

1821373812 — EL CENTRO FAMILY HEALTH
Practice Location Address:

711 BOND ST.
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax: 505-747-1004

1336015312 — KATLYN MAEGAN BRANTLEY
Practice Location Address:

711 E BOND ST
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax:

1366338568 — BLOSSOM & THRIVE THERAPY CO LLC
Practice Location Address:

745 N RIVERSIDE DR STE F
ESPANOLA, NM
87532-2889

Practice Phone: 575-770-2876
Practice Fax:

Directions to “ DR. JOHN G LANG PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.