Basic Information
| Provider Information | |||||||||
| NPI: | 1235520552 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMPSON | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ANN MCCAIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSYD, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4553 BOARDWALK LN | ||||||||
| Address2: | |||||||||
| City: | ORCUTT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934556632 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 401 E CYPRESS AVE | ||||||||
| Address2: | |||||||||
| City: | LOMPOC | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934366806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058651940 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2015 | ||||||||
| LastUpdateDate: | 05/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 105069 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | IMF87638 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.