Provider Demographics
NPI:1629002092
Name:LANG, ARIEL JANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:JANNA
Last Name:LANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 RIO SAN DIEGO DR # MC116A4Z
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1622
Mailing Address - Country:US
Mailing Address - Phone:619-400-5173
Mailing Address - Fax:619-400-5171
Practice Address - Street 1:8810 RIO SAN DIEGO DR # MC116A4Z
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1622
Practice Address - Country:US
Practice Address - Phone:619-400-5173
Practice Address - Fax:619-400-5171
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY1539103TA0400X
CAPSY16539103TA0700X, 103TB0200X, 103TC0700X, 103TH0100X, 103T00000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy