Douglas Wayne Larson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY9281 Issued in CA

Practice address

1430 E Cooley Dr
Suite 209
Colton, CA 92324-3934

Phone

(909) 798-8999

NPI assigned

Apr 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801011580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11454 GOLDEN GATE DR",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923999705",
            "telephone_number": "909-798-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 E COOLEY DR",
            "address_2": "SUITE 209",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243934",
            "telephone_number": "909-798-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DOUGLAS",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Lankford
• Shantae Lankford, RN
• Consuelo Yannet Lara Zaragoza
• Fernanda Kathy Lara, NP
• Gregory S Larsen, D.O.
• Kareem Latif
• Maurice Lauderdale
• Mary Kay Laurent, M.A.
• Patsy Lavender
• Thomas Bernard Law, OD

• Clinical Psychologist in Colton, CA
• Providers in Colton, 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 8, 2007; 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.