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General NPI Number Information
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NPI Number | 1548285380
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Entity Type | Individual
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Provider Name | RITA W. LARSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 SAN ANTONIO CIR SUITE 200
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-1254
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Country | US
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Telephone | 650-941-2212
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Fax | 650-965-2820
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Provider Business Mailing Address
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Address Line | 201 SAN ANTONIO CIR SUITE 200
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-1254
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Country | US
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Telephone | 650-941-2212
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Fax | 650-965-2820
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY5939
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License Number State | CA
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