Provider Demographics
NPI:1922320050
Name:THOMPSON, JEFFREY FRANK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:FRANK
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46141 MIRAMAR WAY STE 1
Mailing Address - Street 2:P.O. BOX 452135
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92145-2135
Mailing Address - Country:US
Mailing Address - Phone:858-577-7151
Mailing Address - Fax:858-577-7154
Practice Address - Street 1:46141 MIRAMAR WAY
Practice Address - Street 2:NAVAL CONSOLIDATED BRIG, MIRAMAR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92145-2135
Practice Address - Country:US
Practice Address - Phone:858-577-7151
Practice Address - Fax:858-577-7154
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA260561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical