Provider Demographics
NPI:1750367298
Name:LANE ITALIANE, JAMES RICHARD (BC-HIS, ACA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:LANE ITALIANE
Suffix:
Gender:M
Credentials:BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24022 CALLE DE LA PLATA
Mailing Address - Street 2:SUITE 415
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3626
Mailing Address - Country:US
Mailing Address - Phone:949-859-7553
Mailing Address - Fax:949-859-9256
Practice Address - Street 1:24022 CALLE DE LA PLATA
Practice Address - Street 2:SUITE 415
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3626
Practice Address - Country:US
Practice Address - Phone:949-859-7553
Practice Address - Fax:949-859-9256
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA756237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0007560OtherMEDICAL