MEDICARE: JUDITH L. THOMPSON MFT

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
1	106H00000X	Marriage & Family Therapist	MFT41343	CA

General Provider Information

NPI Number	:	1881731206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH L. THOMPSON MFT

Provider Business Mailing Address
First Line	:	1380 EAST AVE STE 124 PMB 173
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973
Country	:	US
Telephone Number	:	530-592-6322
Fax Number	:	530-636-4888

Provider Business Practice Location Address
First Line	:	1074 EAST AVE STE A4
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-1052
Country	:	US
Telephone Number	:	530-592-6322
Fax Number	:	530-636-4888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	04/26/2018

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