MRS. KELLI L LANGE


Address: 17482 Amaganset Way, Tustin, CA 92780-2510
Phone: 7142921398

MRS. KELLI L LANGE (NPI# 1598296154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598296154
Entity Type Individual
Full Name MRS. KELLI L LANGE
Credential RN, IBCLC
Practice Address 17482 Amaganset Way
Tustin
CA 92780-2510
Practice Telephone 7142921398
Mailing Telephone 7142921398
Enumeration Date 2017-03-24
Last Update Date 2017-03-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 545992 CA Nursing Service Providers
Y 163WL0100X Registered Nurse
Specialization: Lactation Consultant
L-85403 CA Nursing Service Providers

Office Location

Street Address 17482 AMAGANSET WAY
City TUSTIN
State CA
Zip Code 92780-2510

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1255829503 Hw Physical Therapy Physical Therapist 250 El Camino Real Ste 100, Tustin, CA 92780 2018-04-23
1912494352 Gary Wayne Mcbeath Marriage & Family Therapist 17821 E 17th Street, Suite # 260, Tustin, CA 92780 2018-04-20
1104334598 Catherine Bogues Speech-Language Pathologist 661 West 1st Street, Suite E, Tustin, CA 92780 2018-01-19
1972019941 Lighthouse Behavioral Solutions Behavioral Analyst 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 2017-12-28
1629597299 Lifecab, LLC Non-emergency Medical Transport (VAN) 13732 Newport Ave, Suite #1, Tustin, CA 92780 2017-09-14
1437606555 Tustin Speech Therapy, Inc. Speech-Language Pathologist 661 West First Street, Suite E, Tustin, CA 92780 2016-09-07
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Taxonomy Information

Taxonomy Code 163WL0100X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Lactation Consultant

Taxonomy Definition

Definition to come...

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Competitor

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City TUSTIN
Zip Code 92780

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Dataset Information

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.

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