Healthcare Provider Details

I. General information

NPI: 1417892647
Provider Name (Legal Business Name): SANAI MARIE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 W CHRISTOPHER ST
WEST COVINA CA
91790-3761
US

IV. Provider business mailing address

3836 HEPBURN AVE
LOS ANGELES CA
90008-1923
US

V. Phone/Fax

Practice location:
  • Phone: 626-856-1601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: