Healthcare Provider Details

I. General information

NPI: 1043256753
Provider Name (Legal Business Name): JANE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3331 POWER INN RD SUITE 220
SACRAMENTO CA
95826-3889
US

IV. Provider business mailing address

3331 POWER INN RD SUITE 220
SACRAMENTO CA
95826-3889
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-4853
  • Fax:
Mailing address:
  • Phone: 916-875-4853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number648099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: