Robert Douglas Larson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30603 Issued in CA

Practice address

5349 College Ave
Oakland, CA 94618-1416

Phone

(510) 306-4472

NPI assigned

Jul 7, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Institute for Psychotherapy

  • Voluntary or Charitable Agency
  • San Rafael, CA
  • NPI 1760403794
  NPD (past)
• Community Institute for Psychotherapy

  • Community/Behavioral Health Agency
  • San Rafael, CA
  • NPI 1780995258
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1023320090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 COLLEGE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181416",
            "telephone_number": "510-306-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5349 COLLEGE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181416",
            "telephone_number": "510-306-4472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Lincoln Avenue",
            "address_2": "#201",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "94901",
            "country_code": "US",
            "telephone_number": "415-459-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ROBERT",
        "middle_name": "DOUGLAS",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamon Larry, PA-C
• Alys Larsen
• Heidi L. Larsen, MD
• Famy Lam Larson
• Kimberly Anne Larson, MD
• Stephen Michael Larson
• Susan P Larson
• Alexandra M. Lascano-Rusu
• Bhrett Allison Lash, MD
• Emily Lash, M.D.

• Clinical Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.