Individual provider Active NPI

Yoshado Kinte Lang

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1073694394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
21442 Issued in CA
Practice address
1720 E 120TH St
Los Angeles, CA 90059-3052
Phone
(310) 668-5317
Fax
(310) 223-0621
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 21442 CA Primary

Addresses

Primary practice location

1720 E 120TH St
Los Angeles, CA 90059-3052

Mailing address

645 Chestnut Ave
# 105
Long Beach, CA 90802-1208
Phone (562) 437-9767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000533 CA Practitioner - Clinical Psychologist 7113052804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Dec 22, 2009 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Dec 22, 2009 Accepting new patients

Locations

1720 E 120th St
Los Angeles, CA 90059
Phone (310) 668-4272

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073694394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 CHESTNUT AVE",
            "address_2": "# 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021208",
            "telephone_number": "562-437-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593052",
            "telephone_number": "310-668-5317",
            "fax_number": "310-223-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "YOSHADO",
        "middle_name": "KINTE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.