Healthcare Provider Details

I. General information

NPI: 1477671709
Provider Name (Legal Business Name): ARTHEA J. LARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

IV. Provider business mailing address

587 PRESCOTT ST
PASADENA CA
91104-2861
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax:
Mailing address:
  • Phone: 626-798-4043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number42616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: