Provider Demographics
NPI:1255779120
Name:LANGLEY, LESLIE A (DNP-BC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:LANGLEY
Suffix:
Gender:
Credentials:DNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 WAUKEGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-1622
Mailing Address - Country:US
Mailing Address - Phone:323-568-1654
Mailing Address - Fax:323-826-5346
Practice Address - Street 1:4940 VAN NUYS BLVD STE 307
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1700
Practice Address - Country:US
Practice Address - Phone:818-849-6411
Practice Address - Fax:818-582-3134
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP22671363L00000X, 364SP0808X
CA22671363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACALIFORNIAMedicaid
CA363LP0808XMedicaid