| Doctor Name: | MS. KATHLEEN ANN LARSON |
| NPI Number: | 1225182769 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | LCS6532 |
| Business Practice Address: | 1337 Camino Del Mar Ste B Del Mar, CA - 92014 |
| Business Phone Number: | 8587922289 |
| Business Fax Number: | 8587920639 |
| Mailing Address: | 13546 Landfair Rd, SAN DIEGO |
| State: | CA |
| Postal Code: | 921302026 |
| Phone Number: | 8587922289 |
| Fax Number: | 8587920639 |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS6532 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |