Provider Demographics
NPI:1821232927
Name:LANG, SALLY C (CNM)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:C
Last Name:LANG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:760-901-5155
Mailing Address - Fax:760-633-6870
Practice Address - Street 1:332 SANTA FE DR
Practice Address - Street 2:SUITE 115
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5143
Practice Address - Country:US
Practice Address - Phone:760-901-5155
Practice Address - Fax:760-633-6870
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2019-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN677770176B00000X
CANMW1858367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife