Provider Demographics
NPI:1659063964
Name:LENG, JANE JENG-ROSE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:JENG-ROSE
Last Name:LENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-7018 KAHEA ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2301
Mailing Address - Country:US
Mailing Address - Phone:971-248-9071
Mailing Address - Fax:
Practice Address - Street 1:92-7018 KAHEA ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2301
Practice Address - Country:US
Practice Address - Phone:971-248-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL55091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty