Individual
JENNIFER LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2707 GALLOP DR, SANTA ROSA, CA 95407-4541
(415) 734-8321
Mailing address
2707 GALLOP DR, SANTA ROSA, CA 95407-4541
(415) 734-8321
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH43955
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH43955
BOARD OF PHARMACY CALIFORNIA
CA
Enumeration date
10/28/2015
Last updated
10/28/2015
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