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General NPI Number Information
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NPI Number | 1245441351
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Entity Type | Individual
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Provider Name | LARO VIRGINIA THOMPSON PH.D
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23 ALTRARINDA SUITE 214
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City | ORINDA
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State | CA
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Zip | 94563
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Country | US
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Telephone | 925-254-3606
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Fax |
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Provider Business Mailing Address
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Address Line | 110 BROOKSIDE RD
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City | ORINDA
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State | CA
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Zip | 94563-3706
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Country | US
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Telephone | 925-254-3606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | PSY6780
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License Number State | CA
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