Healthcare Provider Details

I. General information

NPI: 1629839725
Provider Name (Legal Business Name): MS. ANNU MARIA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 ACTIS RD
BAKERSFIELD CA
93309-5911
US

IV. Provider business mailing address

3819 CORNERSTONE WAY
BAKERSFIELD CA
93311-1175
US

V. Phone/Fax

Practice location:
  • Phone: 661-831-8331
  • Fax:
Mailing address:
  • Phone: 775-450-0236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: