Doctor Name: | DR. LARO VIRGINIA THOMPSON |
NPI Number: | 1245441351 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | PSY6780 |
Business Practice Address: | 23 Altrarinda Suite 214 Orinda, CA - 94563 |
Business Phone Number: | 9252543606 |
Business Fax Number: | |
Mailing Address: | 110 Brookside Rd, ORINDA |
State: | CA |
Postal Code: | 945633706 |
Phone Number: | 9252543606 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TF0000X |
License Number: | PSY6780 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Family |
Taxonomy Definition: |