| Kelly L. Lange Psychology, A Professional Corporation | |
|
9606 Tierra Grande St Suite 107 San Diego CA 92126-6501 | |
| (858) 693-3113 | |
| Not Available |
| Full Name | Kelly L. Lange Psychology, A Professional Corporation |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 9606 Tierra Grande St, San Diego, California |
| Authorized Official Name and Position | Kelly L. Lange (CLINICAL NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 8582184601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly L. Lange Psychology, A Professional Corporation 9606 Tierra Grande St Suite 107 San Diego CA 92126-6501 Ph: (858) 693-3113 | Kelly L. Lange Psychology, A Professional Corporation 9606 Tierra Grande St Suite 107 San Diego CA 92126-6501 Ph: (858) 693-3113 |
| NPI Number | 1235337528 |
|---|---|
| Provider Enumeration Date | 07/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235337528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 21401 (California) | Primary |
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