Bascom, Larry

Bascom, Larry is an sole proprietor health care provider with primary practice located at 1531 Chapala St Ste 2 , Santa Barbara CA 93101-3047. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Bascom, Larry can be contacted via phone (805) 962-2324.

Contact Information

Primary practice address
1531 Chapala St Ste 2 Santa Barbara CA 93101-3047
Phone: (805) 962-2324
Fax: (805) 687-5688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY11679 California
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY11679 California

Profile Details

NPI number 1548295793
LBN Legal business name Bascom, Larry
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548295793 NPPES
California Other OPL116791 BLUE SHIELD

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