Healthcare Provider Details

I. General information

NPI: 1114647179
Provider Name (Legal Business Name): JOSLYN PAIGE THOMAS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11370 ANDERSON ST STE 1100
LOMA LINDA CA
92354-3450
US

IV. Provider business mailing address

11370 ANDERSON ST STE 1100
LOMA LINDA CA
92354-3450
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-2830
  • Fax: 909-558-2602
Mailing address:
  • Phone: 909-558-2830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number114343
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114343
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95024662
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: