Individual
DR. LARRY BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1531 CHAPALA ST STE 2, SANTA BARBARA, CA 93101-3047
(805) 962-2324
(805) 687-5688
Mailing address
1531 CHAPALA ST STE 2, SANTA BARBARA, CA 93101-3047
(805) 962-2324
(805) 687-5688
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY11679
CA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY11679
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPL116791
BLUE SHIELD
CA
Enumeration date
07/12/2006
Last updated
09/11/2025
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