Provider Demographics
NPI:1396849311
Name:THOMASSON, MELISSA J (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N H ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-6026
Mailing Address - Country:US
Mailing Address - Phone:805-245-8652
Mailing Address - Fax:
Practice Address - Street 1:205 N H ST
Practice Address - Street 2:SUITE 214
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6026
Practice Address - Country:US
Practice Address - Phone:805-245-8652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10218103TC0700X
CAMFC12439106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist