LARISSA LARSEN (NPI# 1063733426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063733426 |
| Entity Type | Individual |
| Full Name | LARISSA LARSEN |
| Credential | M.D. |
| Practice Address |
2460 N Ponderosa Dr Ste A117 Camarillo CA 93010-2468 |
| Practice Telephone | 8054300002 |
| Practice Fax Number | 8053891245 |
| Mailing Telephone | 8054300002 |
| Mailing Fax Number | 8053891245 |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2020-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | A118359 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538425327 | Larissa Larsen | Nurse Practitioner | 7440 Fm 1960 Rd E, Humble, TX 77346-3129 | 2012-04-05 |
| Street Address |
2460 N PONDEROSA DR STE A117 |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93010-2468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518953512 | Bonnie Casey Quinton | Social Worker | 2460 N Ponderosa Dr, Suite A-110, Camarillo, CA 93010-2375 | 2005-09-25 |
| 1073044236 | Align Foot and Ankle Center Inc A | Podiatrist | 2460 N Ponderosa Dr, A-105, Camarillo, CA 93010-2398 | 2017-03-21 |
| 1801230719 | Camarillo Surgical Center Associates Inc | Clinic/Center | 2460 N Ponderosa Dr, Suite A-116, Camarillo, CA 93010-2398 | 2013-04-22 |
| 1598006652 | Daniel Gene Kolder, M.d. A California Professional Corporation | Plastic Surgery | 2460 N Ponderosa Dr, Suite A-117, Camarillo, CA 93010-2398 | 2013-03-13 |
| 1417240862 | Robert S Improta Md, A Medical Corp | Plastic Surgery | 2460 N Ponderosa Dr, # A117, Camarillo, CA 93010-2398 | 2011-05-18 |
| 1134362312 | Haimesh Shah | Preventive Medicine | 2460 N Ponderosa Dr, Sutie A101, Camarillo, CA 93010-2398 | 2009-04-17 |
| 1033305677 | Hai-en Peng | Podiatrist | 2460 N Ponderosa Dr, Ste A105, Camarillo, CA 93010-2375 | 2007-09-18 |
| 1003021205 | Dean Kenton Amundsen | Optometrist | 2460 N Ponderosa Dr, Suite A-101, Camarillo, CA 93010-2398 | 2007-05-11 |
| 1760581003 | Anacapa Ambulatory Surgical Center | Clinic/Center | 2460 N Ponderosa Dr, A116, Camarillo, CA 93010-2398 | 2006-09-22 |
| 1558330340 | Cynthia Ann Giangreco | Physical Therapist | 2460 N Ponderosa Dr, Ste. A109, Camarillo, CA 93010-2375 | 2006-03-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261366 | Edith Gallardo | Behavior Technician | 400 Mobile Avenue Suite A-3, Camarillo, CA 93010 | 2020-10-05 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1518509678 | Esther Marie Brown Gonzalez | Technician | 2826 Munson St, Camarilla, CA 93010 | 2019-10-10 |
| 1023666385 | Nancy Monetta Wigert | Speech-Language Pathologist | 155 Granada Street #a, Camarillo, CA 93010 | 2019-08-29 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1861977662 | Marina Wischnack | Psychologist | 1200 Paseo Camarillo, Suite 245, Camarillo, CA 93010 | 2018-09-27 |
| 1417430620 | Peter Lawrence Mcdermott | Anesthesiology | 141 Lapatera Drive, Camarillo, CA 93010 | 2018-09-13 |
| 1689162521 | Mehgan Lynn Lambert | Specialist | 333 Skyway Drive, Camarillo, CA 93010 | 2018-04-26 |
| 1134643208 | Hailey Kay Kohler | Social Worker | 692 Spring Oak Road Unit 721, Camarillo, CA 93010 | 2017-08-01 |
| 1174052369 | Demi Shugrue | Counselor | 2021 Sperry Ave, Suite 37, Ventura, CA 93010 | 2017-06-09 |
| Find all providers in zip 93010 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801180807 | Robert Lee | Dermatology | 2438 N Ponderosa Dr Ste C105, Camarillo, CA 93010-2465 | 2011-06-07 |
| 1982600011 | Ross Stuart Kaplan | Dermatology | 3615 Las Posas Rd, Ste F100, Camarillo, CA 93010-1479 | 2005-06-23 |
| 1003840869 | Jill Serene Mines | Dermatology | 3901 Las Posas Rd, #108, Camarillo, CA 93010-1501 | 2006-07-10 |
| 1619905437 | Gerald Nathan Karpman | Dermatology | 2438 N Ponderosa Dr, C-105, Camarillo, CA 93010-2369 | 2006-06-29 |
| 1306886429 | Affiliated Dermatologists, Inc. | Dermatology | 3901 Las Posas Rd, Suite 108, Camarillo, CA 93010 | 2006-06-07 |
| 1184697658 | Ryan D Wells | Dermatology | 3901 Las Posas Rd, Suite 17, Camarillo, CA 93010-1501 | 2006-02-07 |
| 1225013105 | Edward A. Searle | Dermatology | 3901 Las Posas Rd, Suite #108, Camarillo, CA 93010-1501 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.