Provider Demographics
NPI:1598091217
Name:THOMPSON, PATRICK BARDON (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:BARDON
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4065 19TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2561
Mailing Address - Country:US
Mailing Address - Phone:415-672-8099
Mailing Address - Fax:
Practice Address - Street 1:825 VAN NESS AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-7891
Practice Address - Country:US
Practice Address - Phone:415-775-7766
Practice Address - Fax:415-775-7730
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS260551041C0700X
DCLC3033441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical