Healthcare Provider Details

I. General information

NPI: 1972473395
Provider Name (Legal Business Name): JAMES TOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31946 MISSION TRL STE B
LAKE ELSINORE CA
92530-4539
US

IV. Provider business mailing address

31946 MISSION TRL STE B
LAKE ELSINORE CA
92530-4539
US

V. Phone/Fax

Practice location:
  • Phone: 951-471-4300
  • Fax:
Mailing address:
  • Phone: 951-471-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1972473395
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1972473395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: