Healthcare Provider Details

I. General information

NPI: 1114847985
Provider Name (Legal Business Name): JOSIAH BENJERMIN K THOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY STE 210
BAKERSFIELD CA
93309-2664
US

IV. Provider business mailing address

5121 STOCKDALE HWY STE 210
BAKERSFIELD CA
93309-2664
US

V. Phone/Fax

Practice location:
  • Phone: 661-558-1145
  • Fax:
Mailing address:
  • Phone: 661-558-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-ZXPHOE
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: