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NPI Code Detail

MEDICARE: JAMARI WILLS CENTRELL THOMAS

MEDICARE:   JAMARI WILLS CENTRELL THOMAS
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1083183990
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMARI WILLS CENTRELL THOMAS
Provider Business Mailing Address
First Line : 9332 VISTA CT
Second Line :
City : OAKLAND
State : CA
Zip : 94603-1906
Country : US
Telephone Number : 510-798-0887
Fax Number :
Provider Business Practice Location Address
First Line : 9332 VISTA CT
Second Line :
City : OAKLAND
State : CA
Zip : 94603-1906
Country : US
Telephone Number : 510-798-0887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2018
Last Update Date : 11/20/2018

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Directions to “ JAMARI WILLS CENTRELL THOMAS ” Practice Location

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