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NPI Code Detail

MEDICARE: MR. LARRY W DAULONG

MEDICARE:  MR. LARRY W DAULONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659434777
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LARRY W DAULONG
Provider Business Mailing Address
First Line : 2261 ELM ST
Second Line : COUNTY OF NAPA HHSA, CFBH
City : NAPA
State : CA
Zip : 94559-3721
Country : US
Telephone Number : 707-259-8676
Fax Number : 707-259-8651
Provider Business Practice Location Address
First Line : 2261 ELM ST
Second Line : COUNTY OF NAPA HHSA, CFBH
City : NAPA
State : CA
Zip : 94559-3721
Country : US
Telephone Number : 707-259-8676
Fax Number : 707-259-8651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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Directions to “ MR. LARRY W DAULONG ” Practice Location

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