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NPI Code Detail

MEDICARE: ROBBIE THOMPSON I CADC-II CA

MEDICARE: ROBBIE THOMPSON I CADC-II CA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorAII6891214CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AII6891214OTHERCARECOVERY SPECIALIST

General Provider Information

NPI Number : 1366987646
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBBIE THOMPSON I CADC-II CA
Provider Business Mailing Address
First Line : 1502 W TULARE AVE
Second Line :
City : VISALIA
State : CA
Zip : 93277-3543
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 120 W SCHOOL AVE
Second Line :
City : VISALIA
State : CA
Zip : 93291-4925
Country : US
Telephone Number : 559-625-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2016
Last Update Date : 05/08/2023

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