Provider Demographics
NPI:1023170156
Name:LANG, BRENDA (MFT)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 MONTSALAS DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5262
Mailing Address - Country:US
Mailing Address - Phone:831-372-1863
Mailing Address - Fax:831-372-5920
Practice Address - Street 1:412 MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3306
Practice Address - Country:US
Practice Address - Phone:831-372-1863
Practice Address - Fax:831-372-5920
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 33063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist