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NPI Code Detail

MEDICARE: MRS. EVGENIA LARKIN

MEDICARE: MRS. EVGENIA LARKIN
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1710405931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EVGENIA LARKIN
Provider Business Mailing Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number : 415-861-0257
Provider Business Practice Location Address
First Line : 1120 GORDON LN
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-5636
Country : US
Telephone Number : 707-527-3249
Fax Number : 707-579-6061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2017
Last Update Date : 09/07/2017

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Directions to “ MRS. EVGENIA LARKIN ” Practice Location

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