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NPI Code Detail

MEDICARE: DIEGO TOMMASO THOMPSON MA

MEDICARE: DIEGO TOMMASO THOMPSON MA
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
1103T00000XPsychologist

General Provider Information

NPI Number : 1962345264
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEGO TOMMASO THOMPSON MA
Provider Business Mailing Address
First Line : 117 E NORTHERN PKWY
Second Line :
City : BALTIMORE
State : MD
Zip : 21212-2902
Country : US
Telephone Number : 443-520-2205
Fax Number :
Provider Business Practice Location Address
First Line : 4650 W SUNSET BLVD # 53
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number : 323-361-3849
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2026
Last Update Date : 04/11/2026

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Directions to “ DIEGO TOMMASO THOMPSON MA” Practice Location

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