MEDICARE: ANNE SETON THOMPSON S.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	A5417368	CA

General Provider Information

NPI Number	:	1003128711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE SETON THOMPSON S.P.

Provider Business Mailing Address
First Line	:	1625 STOCKTON BLVD
Second Line	:	SUITE 103
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-7053
Country	:	US
Telephone Number	:	916-478-6570
Fax Number	:	916-478-6575

Provider Business Practice Location Address
First Line	:	1625 STOCKTON BLVD
Second Line	:	SUITE 103
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-7098
Country	:	US
Telephone Number	:	916-478-6570
Fax Number	:	916-478-6575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2010
Last Update Date	:	07/10/2010

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Directions to “ ANNE SETON THOMPSON S.P.” Practice Location

Language	Start Address	Practice Location

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