Healthcare Provider Details

I. General information

NPI: 1497215354
Provider Name (Legal Business Name): MEGAN A THOMPSON EDD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN A MCELROY EDD

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 CANYON CREST DR STE 204
RIVERSIDE CA
92507-6035
US

IV. Provider business mailing address

5051 CANYON CREST DR STE 204
RIVERSIDE CA
92507-6035
US

V. Phone/Fax

Practice location:
  • Phone: 951-682-1488
  • Fax: 951-682-1485
Mailing address:
  • Phone: 951-682-1488
  • Fax: 951-682-1485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: