Provider Demographics
NPI:1003288655
Name:THOMPSON, SACHEEN
Entity Type:Individual
Prefix:MS
First Name:SACHEEN
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-0374
Mailing Address - Country:US
Mailing Address - Phone:925-753-2156
Mailing Address - Fax:
Practice Address - Street 1:3727 SUNSET LN
Practice Address - Street 2:STE 210
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6134
Practice Address - Country:US
Practice Address - Phone:925-753-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF70104101Y00000X
CA104870106H00000X
CA132533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor