Theresa Larson, DPT, CSCS, SFMA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 39650 Issued in CA

Practice address

3027 Olive St
San Diego, CA 92104-5002

Phone

(877) 854-1343

NPI assigned

Feb 4, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1144569625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33080",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921632080",
            "telephone_number": "877-854-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 OLIVE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045002",
            "telephone_number": "877-854-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "THERESA",
        "credential": "DPT, CSCS, SFMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 39650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krysten Larson
• Phillip Erik Larson, P.T. A.
• Sarah Nichole Larson, PTA
• Shaheen Larson, MA OTR/L
• Shawna Larai Larson, J.D., M.S.W.
• Victoria Larson, MA CF-SLP
• William Evert Larson, D.M.D.
• Ciara Dawn Larue-Sternberg, CPSS
• David E. Larue, DO
• Michele Larue, PH.D.

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.