Provider Demographics
NPI:1013655919
Name:THOMPSON, ALYSON (MS, LMFT)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 HEMLOCK RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-5540
Mailing Address - Country:US
Mailing Address - Phone:714-794-9618
Mailing Address - Fax:
Practice Address - Street 1:817 HEMLOCK RIDGE CT
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-5540
Practice Address - Country:US
Practice Address - Phone:714-794-9618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist