Provider Demographics
NPI:1508546466
Name:LANGILLE, LISA KELLEY HOPE (CBD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KELLEY HOPE
Last Name:LANGILLE
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 AUCKLAND AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3510
Mailing Address - Country:US
Mailing Address - Phone:757-651-3865
Mailing Address - Fax:
Practice Address - Street 1:5317 AUCKLAND AVE APT 1
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3510
Practice Address - Country:US
Practice Address - Phone:757-651-3865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula