Provider Demographics
NPI:1437469103
Name:THOMPSON, JONATHAN W II
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:W
Last Name:THOMPSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 COAST VILLAGE RD STE 1-720
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2737
Mailing Address - Country:US
Mailing Address - Phone:805-500-8369
Mailing Address - Fax:
Practice Address - Street 1:1114 STATE ST STE 201
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2717
Practice Address - Country:US
Practice Address - Phone:805-500-8369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120144106H00000X
172V00000X
CA134099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker