Healthcare Provider Details

I. General information

NPI: 1154584480
Provider Name (Legal Business Name): WILLIAM JOHN THOMPSON PSY.D. LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1276 N PALM CANYON DR SUITE 102
PALM SPRINGS CA
92262-4411
US

IV. Provider business mailing address

PO BOX 997
RANCHO MIRAGE CA
92270-0997
US

V. Phone/Fax

Practice location:
  • Phone: 760-902-1164
  • Fax:
Mailing address:
  • Phone: 760-902-1164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 45954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: