Wolford, Larissa Rose

Wolford, Larissa Rose is an sole proprietor health care provider with primary practice located at 1683 Novato Blvd Ste 8 , Novato CA 94947-3284. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Wolford, Larissa Rose can be contacted via phone (415) 609-4077.

Contact Information

Primary practice address
1683 Novato Blvd Ste 8 Novato CA 94947-3284
Phone: (415) 609-4077
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 47710 California
Behavioral Health & Social Service Providers / Professional 101YP2500X 1065 California
Behavioral Health & Social Service Providers / School 101YS0200X 140082874 California

Profile Details

NPI number 1386920189
LBN Legal business name Wolford, Larissa Rose
Credentials M.A., LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2011
Last updated Jan 9th, 2016 - about 10 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 1386920189 NPPES
California Other 13678958 CAQH

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