Look up the most recent NPI and PECOS records

Jennifer Leevonne Larson

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

8825 Aero Dr Ste 305, San Diego, CA 92123-2270

(858) 571-1964

PECOS Enrollment

Based on the most recent information from CMS, provider Jennifer Leevonne Larson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1326305988
Provider Type
Individual
Full Name
Larson, Jennifer Leevonne
Gender
Female

Sole Proprietor
Yes
Enumeration Date
4/19/2012
Last Updated
9/13/2024

Contact Information

Practice Location

8825 Aero Dr Ste 305, San Diego, CA 92123-2270

(858) 571-1964

Unlisted Fax

Mailing Location

8825 Aero Dr Ste 305, San Diego, CA 92123-2270

(858) 571-1964

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0804X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License A130546 California
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License A130546 California
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Jennifer Leevonne Larson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Do, Natalie Tram

Reddy, Sree Vaishnavi

Lozano Camhi, Michelle Irene

Gibney, Joshua Mark

Hong, Suzie

Richard L Buccigross Md A Medical Corporation

Solway, Karen E

Sidhu, Shawn Singh