Active NPI
Vang Leng Mouanoutoua, PH.D.
- Clinical Psychologist
- Fresno, CA
National Provider Identifier
1568522951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13753
- Practice address
- 2211 N. Fine Street
Fresno, CA 93727 - Phone
- (559) 455-2175
- Fax
- (559) 455-2087
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY13753 | CA | Primary |
Addresses
Primary practice location
2211 N. Fine Street
Fresno, CA 93727
Mailing address
2211 N. Fine Street
Fresno, CA 93727
Phone (559) 455-2175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13753 | CA | MD | Clinical Psychologist |
Interoperability endpoints
- vang.leng.mouanoutoua.1@17661.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568522951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2211 N. FINE STREET",
"city": "FRESNO",
"state": "CA",
"postal_code": "93727",
"telephone_number": "559-455-2175",
"fax_number": "559-455-2087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 N. FINE STREET",
"city": "FRESNO",
"state": "CA",
"postal_code": "93727",
"telephone_number": "559-455-2175",
"fax_number": "559-455-2087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUANOUTOUA",
"first_name": "VANG LENG",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.