Healthcare Provider Details

I. General information

NPI: 1083233977
Provider Name (Legal Business Name): THOMAS PSYCHOLOGY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 02/22/2022
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 CALLE DE BARRANCA
REDLANDS CA
92373-6510
US

IV. Provider business mailing address

1508 BARTON ROAD #186
REDLANDS CA
92373-1410
US

V. Phone/Fax

Practice location:
  • Phone: 909-255-2860
  • Fax: 909-796-0027
Mailing address:
  • Phone: 909-255-2860
  • Fax: 909-796-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. LORRAINE ABARO THOMAS
Title or Position: PRESIDENT
Credential: PSYD
Phone: 909-255-2860