Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY26937 | CA |
NPI | 1053637967 |
---|---|
Provider Name | Andrew W Langdon |
First Address | Folsom, CA 95630-8707 |
Second Address | Folsom, CA 95630-8707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2010 |
Last Update Date | 18/01/2022 |