Provider Demographics
NPI:1992444566
Name:LANGUS, MATTHEW TODD (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:TODD
Last Name:LANGUS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 YORBA ST STE 104
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2041
Mailing Address - Country:US
Mailing Address - Phone:714-393-6111
Mailing Address - Fax:
Practice Address - Street 1:14101 YORBA ST STE 104
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2041
Practice Address - Country:US
Practice Address - Phone:714-393-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT110900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist