1. Home
  2. Directory
  3. California
  4. Fremont
  5. Counselor
  6. NPI Profile

LARISA SOUTHERLAND AMFT
NPI 1902771496
Counselor - Mental Health in Fremont, CA

Active since October 06, 2025
2450 PERALTA BLVD STE 207, FREMONT, CA 94536(510) 200-8705 Get Directions Write a Review

NPPES record last updated: October 6, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Larisa Southerland Amft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARISA SOUTHERLAND AMFT (NPI 1902771496) is an individual mental health provider in Fremont, California, licensed in California (145725) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1902771496
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameLARISA SOUTHERLANDCredential: AMFT
Location Address2450 PERALTA BLVD STE 207Fremont, CA 94536-3826
Mailing AddressPo Box 370272Las Vegas, NV 89137-0272
Phone(510) 200-8705
Sole ProprietorNo
Enumeration DateOctober 6, 2025
NPPES CertifiedOctober 6, 2025
✔ NPI 1902771496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CA · 145725
2450 PERALTA BLVD STE 207, Fremont, CA 94536
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larisa Southerland's NPI number?

The NPI number for Larisa Southerland is 1902771496. It was assigned to this individual provider in the NPPES registry on October 6, 2025.

Where is Larisa Southerland located?

Larisa Southerland practices at 2450 Peralta Blvd Ste 207, Fremont, CA 94536. The listed phone number is (510) 200-8705.

What is Larisa Southerland's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Larisa Southerland was last updated on October 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.