Provider Demographics
NPI:1790836104
Name:LANGENHAN, JESSICA LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LOUISE
Last Name:LANGENHAN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5325 ALTON PKWY STE C-463
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8610
Mailing Address - Country:US
Mailing Address - Phone:714-478-7906
Mailing Address - Fax:
Practice Address - Street 1:275 BATTERY ST STE 650
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3332
Practice Address - Country:US
Practice Address - Phone:800-997-6196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA968272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA96827AMedicare PIN