Active NPI
John G Lang, PH.D.
- Clinical Psychologist
- Espanola, NM
National Provider Identifier
1760582464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 318
- Practice address
- 721 Bond St
Espanola, NM 87532-2729 - Phone
- (505) 753-5811
- Fax
- (505) 747-3210
- NPI assigned
- Sep 22, 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 | 318 | NM | Primary |
Addresses
Primary practice location
721 Bond St
Espanola, NM 87532-2729
Mailing address
721 Bond St
Espanola, NM 87532-2729
Phone (505) 753-5811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35068 | Medicaid | NM |
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 |
|---|---|---|---|
| 318 | NM | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1760582464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 BOND ST",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322729",
"telephone_number": "505-753-5811",
"fax_number": "505-747-3210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 BOND ST",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322729",
"telephone_number": "505-753-5811",
"fax_number": "505-747-3210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "JOHN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "318",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35068",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.