Provider Demographics
NPI:1730495748
Name:LARGESS, CLAUDETTE N (PSYD)
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:N
Last Name:LARGESS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1402
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-1402
Mailing Address - Country:US
Mailing Address - Phone:415-237-1815
Mailing Address - Fax:
Practice Address - Street 1:459 FULTON ST STE 106
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4364
Practice Address - Country:US
Practice Address - Phone:415-237-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical