BERTOS VELASCO LARISSA - NPI: 1699292953


Mood disorder is a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature. The classification is known as mood (affective) disorders in International Classification of Diseases (ICD).

NPI: 1699292953
Entity Type: Person: individual human being who furnishes health care.
Provider First Name: LARISSA
Provider Last Name: BERTOS
Provider Middle Name: VELASCO
Provider Gender Code: F
Provider Enumeration Date: 08/28/2017
Last Update Date: 08/28/2017

Business Address:

Provider First Line Business Mailing Address: 2275 ARLINGTON DR
Provider Business Mailing Address City Name: SAN LEANDRO
Provider Business Mailing Address State Name: CA
Provider Business Mailing Address Postal Code: 94578
Provider Business Mailing Address Country Code (If outside U.S.): US
Phone: 5103171444

Mailing Address:

Provider First Line Business Practice Location Address: 2275 ARLINGTON DR
Provider Business Practice Location Address City Name: SAN LEANDRO
Provider Business Practice Location Address State Name: CA
Provider Business Practice Location Address Postal Code: 94578
Provider Business Practice Location Address Country Code (If outside U.S.): US
Phone: (510) 317-1444

Primary Taxonomy:

Taxonomy Code:
License Number:
License State:
Healthcare Provider Primary Taxonomy Switch: N - The taxonomy is not the primary taxonomy

Secondary Taxonomy:

Taxonomy Code:
License Number: 94972
License State: CA
Healthcare Provider Primary Taxonomy Switch: N - The taxonomy is not the primary taxonomy
Source: The National Provider Identifier

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