Provider Demographics
NPI:1669552691
Name:LANGER, DEANA K (MA, CCCA)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:K
Last Name:LANGER
Suffix:
Gender:F
Credentials:MA, CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10133 AMIGO AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1302
Mailing Address - Country:US
Mailing Address - Phone:818-993-8939
Mailing Address - Fax:
Practice Address - Street 1:7230 MEDICAL CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-4001
Practice Address - Country:US
Practice Address - Phone:818-712-0704
Practice Address - Fax:818-716-0433
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU616174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist