Individual
SHANNON M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-3910
Mailing address
393 E WALNUT ST, 3RD FLOOR PHR SYSTEMS, PASADENA, CA 91188-0001
(000) 000-0000
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA2156
CA
Other
Enumeration date
04/19/2007
Last updated
11/30/2007
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