Larry Bullard, ASW

NPI 1699116897 · on the registry since 2013

Practice

Address: 1350 3rd St
La Verne, CA 91750
Phone: (909) 596-5921
Fax: (909) 596-7583
Organisation at this address: Haynes Family Of Programs
David & Margaret Home, Inc.
David And Margaret Home, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 101

Registry record

Primary taxonomy: 101YM0800X
101YM0800X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2013-07-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California