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NPI Code Detail

MEDICARE: SKYE ANGEL MARIE THUNDER

MEDICARE: SKYE ANGEL MARIE THUNDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1043157373
Entity Type Code : Individual
Provider Name (Legal Business Name) : SKYE ANGEL MARIE THUNDER
Provider Business Mailing Address
First Line : 500 EL CAMINO REAL
Second Line :
City : SANTA CLARA
State : CA
Zip : 95053-1000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1118 MERIDIAN AVE STE 150
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-4352
Country : US
Telephone Number : 408-445-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “ SKYE ANGEL MARIE THUNDER ” Practice Location

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