Provider Demographics
NPI:1932825338
Name:THOMPSON, ANNELISE YANG (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNELISE
Middle Name:YANG
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANNELISE
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:970 N KALAHEO AVE STE A216
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1869
Mailing Address - Country:US
Mailing Address - Phone:626-344-7924
Mailing Address - Fax:
Practice Address - Street 1:970 N KALAHEO AVE STE A216
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1869
Practice Address - Country:US
Practice Address - Phone:626-344-7924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT-800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist