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NPI Code Detail

MEDICARE: KRYSTAL THOMAS

MEDICARE: KRYSTAL 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1659193290
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL THOMAS
Provider Business Mailing Address
First Line : 16255 VENTURA BLVD.
Second Line : STE. 830
City : ENCINO
State : CA
Zip : 91436
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4934 S 900 W STE 31
Second Line :
City : OGDEN
State : UT
Zip : 84405-3777
Country : US
Telephone Number : 801-935-4171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2024
Last Update Date : 10/25/2024

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Directions to “ KRYSTAL THOMAS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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