Provider Demographics
NPI:1063610566
Name:THOMPSON, TERRI LADONNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:LADONNA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E HAMILTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0664
Mailing Address - Country:US
Mailing Address - Phone:408-802-6391
Mailing Address - Fax:408-879-7205
Practice Address - Street 1:900 E HAMILTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0664
Practice Address - Country:US
Practice Address - Phone:408-802-6391
Practice Address - Fax:408-879-7205
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23594103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMS 855IMedicare UPIN