Healthcare Provider Details

I. General information

NPI: 1366962714
Provider Name (Legal Business Name): CYNTHIA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 G ST STE E
MERCED CA
95340-2953
US

IV. Provider business mailing address

731 E YOSEMITE AVE STE B109
MERCED CA
95340-8039
US

V. Phone/Fax

Practice location:
  • Phone: 559-376-8707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number115317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: