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General NPI Number Information
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NPI Number | 1316069693
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Entity Type | Individual
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Provider Name | NINETTE FRANCES LARSON MFT
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 2723 CROW CANYON RD SUITE 209B
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City | SAN RAMON
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State | CA
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Zip | 94583-1635
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Country | US
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Telephone | 925-330-9576
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 ALMOND AVE
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City | WALNUT CREEK
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State | CA
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Zip | 94596-4311
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Country | US
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Telephone | 925-330-9576
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Fax | 925-952-9892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC34241
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License Number State | CA
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