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Contact Information

KENNETH L LARSON, PhD
1891 E ROSEVILLE PKWY STE 100
ROSEVILLE, CA95661-7974
 Phone: 916-789-7082
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KENNETH L LARSON · (Male)

NPI Number 1891806675
Status Active
Credentials PhD
Entity Individual
Enumeration date 08/31/2006
Last updated 09/09/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # PSY16221
  • WA License # PY61229677
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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