Individual
MRS. ADDIE LASHUN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.A.S.I.
Contact information
Practice address
44900 60TH ST W, LANCASTER, CA 93536-7618
(661) 945-8458
(661) 945-8248
Mailing address
PO BOX 25, ACTON, CA 93510-0025
(661) 945-8458
(661) 945-8248
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-T0506291612
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6767
MEDI-CAL
CA
Enumeration date
04/24/2007
Last updated
07/08/2007
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