Provider Demographics
NPI:1609926823
Name:THAYER, MARGARET (PHD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:THAYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S MAIN ST STE 111
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5320
Mailing Address - Country:US
Mailing Address - Phone:925-855-0459
Mailing Address - Fax:
Practice Address - Street 1:1600 S MAIN ST STE 111
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5320
Practice Address - Country:US
Practice Address - Phone:925-855-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14839103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL148390Medicare PIN