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NPI Code Detail

MEDICARE: MS. JUDY ANN THOMPSON M.S.

MEDICARE: MS. JUDY ANN THOMPSON M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor150028CA

General Provider Information

NPI Number : 1417138074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUDY ANN THOMPSON M.S.
Provider Business Mailing Address
First Line : 136 BROAD ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-2925
Country : US
Telephone Number : 415-410-1076
Fax Number :
Provider Business Practice Location Address
First Line : 7200 BANCROFT AVE STE 267
Second Line :
City : OAKLAND
State : CA
Zip : 94605-2408
Country : US
Telephone Number : 510-899-7445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2007
Last Update Date : 03/17/2025

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