Healthcare Provider Details

I. General information

NPI: 1558689877
Provider Name (Legal Business Name): LAARNI J DEGROFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3331 POWER INN RD STE 140
SACRAMENTO CA
95826-3889
US

IV. Provider business mailing address

58923 BUSINESS CENTER DR STE E
YUCCA VALLEY CA
92284-7311
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-2266
  • Fax:
Mailing address:
  • Phone: 760-365-7209
  • Fax: 760-365-7946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number91593
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number62468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: