Healthcare Provider Details

I. General information

NPI: 1891950564
Provider Name (Legal Business Name): SARAH STARLEANA THOMAS MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 08/05/2023
Certification Date: 08/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 E SAMPLE AVE
FRESNO CA
93710-5428
US

IV. Provider business mailing address

PO BOX 9242
FRESNO CA
93791-9242
US

V. Phone/Fax

Practice location:
  • Phone: 559-252-2204
  • Fax:
Mailing address:
  • Phone: 916-753-6343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number90806
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number130362
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: