Healthcare Provider Details

I. General information

NPI: 1487840658
Provider Name (Legal Business Name): LARRY TAORMINA PH. D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 HUNTINGTON AVE 150
SOUTH SAN FRANCISCO CA
94080-5990
US

IV. Provider business mailing address

896 DOGWOOD CT
SAN JOSE CA
95128-4215
US

V. Phone/Fax

Practice location:
  • Phone: 650-246-3829
  • Fax: 650-246-3838
Mailing address:
  • Phone: 408-656-6724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: