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Individual

MRS. MARSHA ANN LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
40 G. ST, B, LOS BANOS, CA 93635-3320
(209) 710-6100
(209) 827-2009
Mailing address
18706 LEXINGTON AVE, DOS PALOS, CA 93620-9712
(209) 769-1493

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN336299
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19269
CA

Other

Enumeration date
04/06/2007
Last updated
05/31/2011
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