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General NPI Number Information
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NPI Number | 1083718381
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Entity Type | Organization
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Legal Business Name | NEUROPSYCH OF LOS ALTOS, A PSYCHOLOGY CORPORATION
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 24044 OAK KNOLL CIR
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City | LOS ALTOS HILLS
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State | CA
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Zip | 94022-5100
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Country | US
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Telephone | 650-941-3002
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Fax |
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Provider Business Mailing Address
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Address Line | 24044 OAK KNOLL CIR
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City | LOS ALTOS HILLS
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State | CA
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Zip | 94022-5100
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Country | US
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Telephone | 650-941-3002
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOROTHY ANN LARSON
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Credential | PH.D.
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Telephone | 650-941-3002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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