Individual
DR. DALE G LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1769 PARK AVE, SUITE 210, SAN JOSE, CA 95126-2029
(408) 554-4320
Mailing address
SANTA CLARA UNIVERSITY, 500 EL CAMINO REAL, SANTA CLARA, CA 95053-0201
(408) 554-4320
(408) 554-2392
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PA7753
CA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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