Provider Demographics
NPI:1003128711
Name:THOMPSON, ANNE SETON (SP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:SETON
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 STOCKTON BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-7053
Mailing Address - Country:US
Mailing Address - Phone:916-478-6570
Mailing Address - Fax:916-478-6575
Practice Address - Street 1:1625 STOCKTON BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7098
Practice Address - Country:US
Practice Address - Phone:916-478-6570
Practice Address - Fax:916-478-6575
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA5417368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist