MEDICARE: MEGAN MARIE THOMAS FNP-BC, PMHNP-BC

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
1	363L00000X	Nurse Practitioner	95014064	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95014064	CA
3	363LF0000X	Family Nurse Practitioner	95014064	CA

General Provider Information

NPI Number	:	1528692761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARIE THOMAS FNP-BC, PMHNP-BC

Provider Business Mailing Address
First Line	:	902 CIRBY WAY
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-4420
Country	:	US
Telephone Number	:	916-789-1798
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 CIRBY WAY
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-4420
Country	:	US
Telephone Number	:	916-789-1798
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	04/11/2025

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