Larisa Beckwith, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17813 Issued in CA

Practice address

764 Faxon Ave
San Francisco, CA 94112-1204

Phone

(310) 562-4048

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Larisa Evans Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1629614144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 FAXON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 FAXON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121204",
            "telephone_number": "310-562-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKWITH",
        "first_name": "LARISA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "PSY17813",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY17813",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "PSY17813",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISA",
            "last_name": "EVANS",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristine Kaye Beckman
• Nancy Beckman, PH.D.
• Walter Beckman, PHD
• Victoria Lemle Beckner, PH.D.
• Monica A Becks, PA
• Ryan James Beckwith, CRNA
• Michael Anthony Beco
• Jeanette Naomi Bedak
• Larry A Bedard, M.D
• Bryant Bedford

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.