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1790127728
LARRY ALLEN JEAN
SAN RAFAEL, CA
NPI
1790127728
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
172V00000X Community Health Worker
Enumeration Date
2013-07-18
Last Update Date
2023-04-12
Business Address
LARRY ALLEN JEAN
3230 KERNER BLVD
SAN RAFAEL, CA 94901-4840
Phone number: 415-847-3209
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Mailing Address
LARRY ALLEN JEAN
36D OLIVA DR
NOVATO, CA 94947-2123
Phone number: 415-450-0105
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