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Individual
MS. JUDY THACH
Active
Individual
MS. JUDY THACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
31753
CA
1041C0700X
Clinical Social Worker
Primary
70044
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
09/21/2009
Last updated
09/17/2021
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