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Individual

DR. JENNIFER LARSEN-EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
2193 AHAKU PL, HONOLULU, HI 96821-1012
(818) 220-1539
Mailing address
2193 AHAKU PL, HONOLULU, HI 96821-1012
(818) 220-1539

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY2123
HI
103TC0700X
Clinical Psychologist
PSY27179
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225400000X
DMH
CA
Enumeration date
07/21/2010
Last updated
01/05/2024
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