Provider Demographics
NPI:1972532802
Name:LARMAN, JODI S
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:S
Last Name:LARMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8014
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91327-8014
Mailing Address - Country:US
Mailing Address - Phone:818-516-5689
Mailing Address - Fax:
Practice Address - Street 1:2650 JONES WAY STE 10
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1215
Practice Address - Country:US
Practice Address - Phone:805-522-1844
Practice Address - Fax:805-522-5345
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20301103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY203010Medicaid
CAWCP20301AMedicare ID - Type Unspecified