DR. KELLY L LANGE (NPI# 1124247226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124247226 |
| Entity Type | Individual |
| Full Name | DR. KELLY L LANGE |
| Credential | PH.D. |
| Practice Address |
9606 Tierra Grande St Suite 107 San Diego CA 92126-6501 |
| Practice Telephone | 8586933113 |
| Mailing Telephone | 8586933113 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY21401 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679884761 | Kelly Elizabeth Lange | Nurse Practitioner | 80 Gardenia Dr Ste B, Covington, LA 70433-9196 | 2010-06-23 |
| 1477064632 | Kelly Lange | Social Worker | 1841 Park Ave, New York, NY 10035-1316 | 2017-10-16 |
| 1568644292 | Kelly Marie Lange | Psychologist | 42189 Ann Arbor Rd E, Plymouth, MI 48170-4370 | 2007-12-05 |
| 1366463804 | Kelly Marie Lange | Chiropractor | 108 E Hersey St, # 2, Ashland, OR 97520-1363 | 2006-07-21 |
| Street Address |
9606 TIERRA GRANDE ST SUITE 107 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92126-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356429336 | Anita L Maloney | Speech-Language Pathologist | 9606 Tierra Grande St, San Diego, CA 92126-6501 | 2006-11-01 |
| 1538669866 | Melanie Barker | Occupational Therapist | 9606 Tierra Grande St, San Diego, CA 92126-6501 | 2018-02-13 |
| 1356857205 | Kristina Zion | Counselor | 9606 Tierra Grande St, San Diego, CA 92126-6501 | 2017-12-14 |
| 1093160830 | Jessica Wood | Speech-Language Pathologist | 9606 Tierra Grande St, Ste 107, San Diego, CA 92126-6501 | 2016-04-29 |
| 1033589643 | Emily Rochfort | Speech-Language Pathologist | 9606 Tierra Grande St, Suite 107, San Diego, CA 92126-6501 | 2015-09-25 |
| 1689041089 | Erica Grace Nicholas | Speech-Language Pathologist | 9606 Tierra Grande St, Suite 107, San Diego, CA 92126-6501 | 2015-09-01 |
| 1699165688 | Kristine Mary Myers | Occupational Therapist | 9606 Tierra Grande St, San Diego, CA 92126-6501 | 2015-01-28 |
| 1750799706 | Heather Newman | Occupational Therapist | 9606 Tierra Grande St, San Diego, CA 92126-6501 | 2014-07-22 |
| 1073854519 | Gillian Dvorak | Speech-Language Pathologist | 9606 Tierra Grande St, #107, San Diego, CA 92126-6501 | 2013-03-07 |
| 1457697351 | Traysa Leighton | Speech-Language Pathologist | 9606 Tierra Grande St, Suite 107, San Diego, CA 92126-6501 | 2012-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730741299 | Eye Connection Optometry, Inc | Optometrist | 9516 Miramar Road, San Diego, CA 92126 | 2019-07-05 |
| 1811450935 | Anne Phabmixay | Student in an Organized Health Care Education/Training Program | Douglas Young Wellness Center, 10717 Camino Ruiz Suite 207, San Diego, CA 92126 | 2019-04-08 |
| 1679035588 | Emily Nguyen | Registered Nurse | 8210 Elston Place, San Diego, CA 92126 | 2019-04-01 |
| 1558832139 | Dana Douglas-hiley | Speech-Language Pathologist | 9606 Tierra Grande St., Suite 107, San Diego, CA 92126 | 2018-12-08 |
| 1275022873 | Breeann Nicole Poulson | Speech-Language Pathologist | 9466 Black Mountain Rd Suite 100, San Diego, CA 92126 | 2018-05-09 |
| 1659878882 | My Phuong Thi Phan | Registered Nurse | 10938 Hyades Way, San Diego, CA 92126 | 2018-04-13 |
| 1083132153 | Ruth Tamar Morales | Occupational Therapist | Children's Ot Services, Inc, 9606 Tierra Grande St., #104, San Diego, CA 92126 | 2017-09-08 |
| 1487184339 | Chelsea Irene Johnson | Marriage & Family Therapist | 8670 New Salem St. Unit 106, San Diego, CA 92126 | 2017-06-14 |
| 1336508506 | Brenda L. Bebal | Nurse Practitioner | 10737 Camino Ruiz; Ste 235, Operation Samahan Health Clinic, San Diego, CA 92126 | 2016-02-17 |
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| Find all providers in zip 92126 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265045975 | Well Psychology, Inc. | Clinical Neuropsychologist | 3525 Del Mar Heights Rd # 1881, San Diego, CA 92130-2199 | 2020-08-24 |
| 1437767399 | Ni Sun-suslow | Clinical Neuropsychologist | 220 Dickinson St # B, San Diego, CA 92103-2071 | 2020-07-16 |
| 1528414430 | Mitchel D Pelrman | Clinical Neuropsychologist | 2430 Palermo Dr, San Diego, CA 92106-1221 | 2016-05-10 |
| 1528468816 | Erin Almklov | Clinical Neuropsychologist | 11512 El Camino Real, 350, San Diego, CA 92130-2087 | 2014-08-25 |
| 1871930404 | Mili Parikh | Clinical Neuropsychologist | 5752 Oberlin Dr # 112, San Diego, CA 92121-1747 | 2013-05-22 |
| 1629329164 | Joanna Jacobus | Clinical Neuropsychologist | 3350 La Jolla Village Dr # Mc151b, San Diego, CA 92161-0002 | 2012-09-24 |
| 1619251790 | Barbara Jean Schrock | Clinical Neuropsychologist | 5989 Cozzens St, San Diego, CA 92122-3724 | 2011-10-06 |
| 1598099657 | Cheryl La Sasso | Clinical Neuropsychologist | 12526 High Bluff Dr Ste 300, San Diego, CA 92130-2067 | 2009-09-22 |
| 1295963288 | Delia Maria Silva | Clinical Neuropsychologist | 1901 1st Ave., Ste 245, San Diego, CA 92101 | 2009-06-29 |
| 1629264130 | Spencer Wetter | Clinical Neuropsychologist | 9648 Caminito Del Feliz, San Diego, CA 92121-1903 | 2007-09-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.