Provider Demographics
NPI:1588737340
Name:THOMSON, BARBARA ANNE (MFT)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANNE
Last Name:THOMSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 GRAND AVE
Mailing Address - Street 2:#4
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4400
Mailing Address - Country:US
Mailing Address - Phone:760-944-7448
Mailing Address - Fax:
Practice Address - Street 1:1767 GRAND AVE
Practice Address - Street 2:#4
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4400
Practice Address - Country:US
Practice Address - Phone:760-944-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist