Provider Demographics
NPI:1700060860
Name:THOMSON, ALICE (MA, PH D)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:
Last Name:THOMSON
Suffix:
Gender:F
Credentials:MA, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E FOOTHILL BLVD
Mailing Address - Street 2:BHRC SAN BERNARDINO CTY DBH
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5230
Mailing Address - Country:US
Mailing Address - Phone:909-580-2141
Mailing Address - Fax:909-580-2866
Practice Address - Street 1:400 N PEPPER AVE
Practice Address - Street 2:ARMC BEH. HLTH-DBH PSYCHIATRIC DIVERSION TRIAGE
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1801
Practice Address - Country:US
Practice Address - Phone:909-580-2141
Practice Address - Fax:909-580-2866
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health