Provider Demographics
NPI:1245441351
Name:THOMPSON, LARO VIRGINIA (PHD)
Entity type:Individual
Prefix:DR
First Name:LARO
Middle Name:VIRGINIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LARO
Other - Middle Name:PEGGY
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:110 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3706
Mailing Address - Country:US
Mailing Address - Phone:925-254-3606
Mailing Address - Fax:
Practice Address - Street 1:23 ALTRARINDA
Practice Address - Street 2:SUITE 214
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563
Practice Address - Country:US
Practice Address - Phone:925-254-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6780103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily