MEDICARE: ALYSON THOMPSON MS, LMFT

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	106H00000X	Marriage & Family Therapist	107410	CA

General Provider Information

NPI Number	:	1013655919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON THOMPSON MS, LMFT

Provider Business Mailing Address
First Line	:	817 HEMLOCK RIDGE CT
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-5540
Country	:	US
Telephone Number	:	714-794-9618
Fax Number	:

Provider Business Practice Location Address
First Line	:	817 HEMLOCK RIDGE CT
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-5540
Country	:	US
Telephone Number	:	714-794-9618
Fax Number	:

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

Provider Enumeration Date	:	05/22/2022
Last Update Date	:	05/22/2022

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