Provider Demographics
NPI:1104091172
Name:LANGLEY, LEE J (MS)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:J
Last Name:LANGLEY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28494 WESTINGHOUSE PL STE 214
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-0934
Mailing Address - Country:US
Mailing Address - Phone:661-297-7255
Mailing Address - Fax:
Practice Address - Street 1:28494 WESTINGHOUSE PL STE 214
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0934
Practice Address - Country:US
Practice Address - Phone:661-297-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33599106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist