Provider Demographics
NPI:1245558535
Name:LARSON, BARBARA ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ELIZABETH
Last Name:LARSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 BOWLING DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2034
Mailing Address - Country:US
Mailing Address - Phone:916-875-0900
Mailing Address - Fax:
Practice Address - Street 1:7001A EAST PKWY
Practice Address - Street 2:SUITE 600
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2501
Practice Address - Country:US
Practice Address - Phone:916-875-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283504163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse