Individual
ALEXIS THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15230 LAKESHORE DR, CLEARLAKE, CA 95422-8107
(707) 995-4500
(707) 944-2401
Mailing address
15230 LAKESHORE DR, CLEARLAKE, CA 95422-8107
(707) 995-4500
(707) 944-2401
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363A00000X
Physician Assistant
Primary
PA64741
CA
Other
Enumeration date
11/26/2019
Last updated
10/21/2024
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