Larsen, Kimberly W.

Larsen, Kimberly W. is an individual health care provider with primary practice located at 7373 West Ln , Stockton CA 95210-3377. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Larsen, Kimberly W. can be contacted via phone (209) 476-2000.

Contact Information

Primary practice address
7373 West Ln Stockton CA 95210-3377
Phone: (209) 476-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A85327 California

Profile Details

NPI number 1134207947
LBN Legal business name Larsen, Kimberly W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134207947 NPPES
California MEDICAID 00A853270

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