Healthcare Provider Details

I. General information

NPI: 1205241122
Provider Name (Legal Business Name): MARIA JOANA ANGELES THOMAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CREEKSIDE DR STE 3600
FOLSOM CA
95630-3446
US

IV. Provider business mailing address

1111 EXPOSITION BLVD STE 300
SACRAMENTO CA
95815-4324
US

V. Phone/Fax

Practice location:
  • Phone: 916-235-7790
  • Fax: 916-235-7791
Mailing address:
  • Phone: 916-929-8564
  • Fax: 916-929-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD191182
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA149260
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: