Provider Demographics
NPI:1265025209
Name:THOMPSON, MARIA GIOVANNA I (LNHA, CTRS, AMFT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GIOVANNA
Last Name:THOMPSON
Suffix:I
Gender:F
Credentials:LNHA, CTRS, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 BLOSSOM WAY
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-1948
Mailing Address - Country:US
Mailing Address - Phone:510-282-3684
Mailing Address - Fax:
Practice Address - Street 1:494 BLOSSOM WAY
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-1948
Practice Address - Country:US
Practice Address - Phone:510-282-3684
Practice Address - Fax:510-929-2099
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA136440106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)