Provider Demographics
NPI:1396836532
Name:GALPERT, LARRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:GALPERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 MARSH ST STE 260
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2985
Mailing Address - Country:US
Mailing Address - Phone:206-898-5190
Mailing Address - Fax:888-548-6740
Practice Address - Street 1:1540 MARSH ST STE 260
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2985
Practice Address - Country:US
Practice Address - Phone:805-781-0217
Practice Address - Fax:888-548-6740
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY2097103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB07780Medicare ID - Type Unspecified