Individual
DR. DOUGLAS WAYNE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1430 E COOLEY DR, SUITE 209, COLTON, CA 92324-3934
(909) 798-8999
Mailing address
11454 GOLDEN GATE DR, YUCAIPA, CA 92399-9705
(909) 798-8999
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY9281
CA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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