| Tina Larson Professional Clinical Counselor Prof Corp | |
|
1255 Treat Blvd Ste 300 Walnut Creek CA 94597-7965 | |
| (703) 980-9205 | |
| Not Available |
| Full Name | Tina Larson Professional Clinical Counselor Prof Corp |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1255 Treat Blvd Ste 300, Walnut Creek, California |
| Authorized Official Name and Position | Kristine U Larson (LICENSED PROFESSIONAL CLINICAL COUN) |
| Authorized Official Contact | 7039809205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Larson Professional Clinical Counselor Prof Corp 1255 Treat Blvd Ste 300 Walnut Creek CA 94597-7965 Ph: (703) 980-9205 | Tina Larson Professional Clinical Counselor Prof Corp 1255 Treat Blvd Ste 300 Walnut Creek CA 94597-7965 Ph: (703) 980-9205 |
| NPI Number | 1053151530 |
|---|---|
| Provider Enumeration Date | 05/30/2024 |
| Last Update Date | 05/30/2024 |
| Certification Date | 05/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053151530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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