Provider Demographics
NPI:1750887253
Name:LADD, THOMAS (BA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LADD
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RICHMOND AREA MULTI SERVICES
Mailing Address - Street 2:3626 BALBOA ST.
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121
Mailing Address - Country:US
Mailing Address - Phone:415-255-3788
Mailing Address - Fax:
Practice Address - Street 1:RICHMOND AREA MULTI SERVICES
Practice Address - Street 2:3626 BALBOA ST.
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121
Practice Address - Country:US
Practice Address - Phone:415-255-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker