MEDICARE: MEGAN ARLENE PATRICK-THOMPSON

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	103TC0700X	Clinical Psychologist	PSY31035	CA

General Provider Information

NPI Number	:	1548327943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ARLENE PATRICK-THOMPSON

Provider Business Mailing Address
First Line	:	536 W VISTA WAY STE A
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92083-5704
Country	:	US
Telephone Number	:	760-758-1650
Fax Number	:	619-233-0453

Provider Business Practice Location Address
First Line	:	536 W VISTA WAY STE A
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92083-5704
Country	:	US
Telephone Number	:	760-758-1650
Fax Number	:	619-233-0453

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	08/29/2024

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