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NPI Code Detail

MEDICARE: RACHEL CHEVONNE THOMPSON ACSW

MEDICARE: RACHEL CHEVONNE THOMPSON ACSW
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
11041C0700XClinical Social Worker106H0000XCA

General Provider Information

NPI Number : 1801320924
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL CHEVONNE THOMPSON ACSW
Provider Business Mailing Address
First Line : 115 N SUTTER ST STE 3
Second Line :
City : STOCKTON
State : CA
Zip : 95202-2401
Country : US
Telephone Number : 209-718-9862
Fax Number :
Provider Business Practice Location Address
First Line : 430 N PILGRIM ST
Second Line :
City : STOCKTON
State : CA
Zip : 95205-4428
Country : US
Telephone Number : 209-395-3553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2017
Last Update Date : 01/05/2021

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