MEDICARE: LAWRENCE THOMPSON JR.

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	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1215888623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE THOMPSON JR.

Provider Business Mailing Address
First Line	:	2161 HARTFORD DR APT 168
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-7733
Country	:	US
Telephone Number	:	530-828-5155
Fax Number	:

Provider Business Practice Location Address
First Line	:	2161 HARTFORD DR APT 168
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-7733
Country	:	US
Telephone Number	:	530-828-5155
Fax Number	:

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

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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