Healthcare Provider Details

I. General information

NPI: 1588869507
Provider Name (Legal Business Name): MISS KATHRYN LYNETTE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 SKYWAY
PARADISE CA
95969-3280
US

IV. Provider business mailing address

PO BOX 8993
RED BLUFF CA
96080-1993
US

V. Phone/Fax

Practice location:
  • Phone: 530-872-2103
  • Fax: 530-872-7784
Mailing address:
  • Phone: 530-892-2274
  • Fax: 530-872-7784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: