Provider Demographics
NPI:1679204119
Name:LAROVA, VERONIKA (PSYD)
Entity type:Individual
Prefix:
First Name:VERONIKA
Middle Name:
Last Name:LAROVA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 GOLDEN HILL RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-7039
Mailing Address - Country:US
Mailing Address - Phone:415-741-4079
Mailing Address - Fax:
Practice Address - Street 1:5625 LINNE RD
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-8443
Practice Address - Country:US
Practice Address - Phone:415-741-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94024875103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical