Southard, Larry E
Southard, Larry E is an individual health care provider with primary practice located at 1255 E Highland Ave Ste 105, San Bernardino CA 92404. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Southard, Larry E can be contacted via phone (909) 881-5250.Contact Information
Primary practice address
1255 E Highland Ave Ste 105
San Bernardino CA 92404
Phone: (909) 881-5250
Fax: (909) 337-2724
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | MFC18620 | California |
Profile Details
NPI number | 1356304380 |
---|---|
LBN Legal business name | Southard, Larry E |
Credentials | MA MFT |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 10th, 2006 |
Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1356304380 | NPPES |
Other | 061147 | HEALTHNET | |
Other | 065571 | HEALTHNET | |
Other | 186380 | HEALTHNET | |
Other | 33B61D | HEALTHNET | |
Other | 5362524 | HEALTHNET | |
Other | 019346 | HEALTHNET | |
Other | 56862099802 | HEALTHNET | |
Other | 3112 | HEALTHNET | |
Other | 386213 | HEALTHNET | |
Other | 6270815 | HEALTHNET | |
Other | 208994 | HEALTHNET | |
Other | MFT18620 | HEALTHNET |
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