Healthcare Provider Details

I. General information

NPI: 1992114557
Provider Name (Legal Business Name): FRANCES THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 BROADWAY SUITE 610
OAKLAND CA
94612-2041
US

IV. Provider business mailing address

111 CHESTNUT ST UNIT 407
SAN FRANCISCO CA
94111-1031
US

V. Phone/Fax

Practice location:
  • Phone: 510-628-9065
  • Fax:
Mailing address:
  • Phone: 408-221-7791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: