Healthcare Provider Details

I. General information

NPI: 1548193105
Provider Name (Legal Business Name): AUDEY KAY THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 PICO BLVD
SANTA MONICA CA
90405-1326
US

IV. Provider business mailing address

1127 ALAMEDA AVE APT C
GLENDALE CA
91201-1353
US

V. Phone/Fax

Practice location:
  • Phone: 310-314-6200
  • Fax:
Mailing address:
  • Phone: 323-762-3685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number684756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: