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Individual

WILLIE LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
2001 SANTA MONICA BLVD STE 380, SANTA MONICA, CA 90404-2179
(310) 899-7500
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95229614
CA
367A00000X
Advanced Practice Midwife
Primary
236523
CA

Other

Enumeration date
01/12/2022
Last updated
07/07/2026
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