Provider Demographics
NPI:1699239855
Name:LARRAZOLO, ADI (LIFE COACH)
Entity type:Individual
Prefix:
First Name:ADI
Middle Name:
Last Name:LARRAZOLO
Suffix:
Gender:F
Credentials:LIFE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 BARBERA CT
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-8200
Mailing Address - Country:US
Mailing Address - Phone:707-225-5071
Mailing Address - Fax:
Practice Address - Street 1:1213 BARBERA CT
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-8200
Practice Address - Country:US
Practice Address - Phone:707-225-5071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor