Provider Demographics
NPI:1497215354
Name:THOMPSON, MEGAN A (EDD)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:A
Other - Last Name:MCELROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:5051 CANYON CREST DR STE 204
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6035
Mailing Address - Country:US
Mailing Address - Phone:951-682-1488
Mailing Address - Fax:951-682-1485
Practice Address - Street 1:5051 CANYON CREST DR STE 204
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6035
Practice Address - Country:US
Practice Address - Phone:951-682-1488
Practice Address - Fax:951-682-1485
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist