Healthcare Provider Details

I. General information

NPI: 1700751195
Provider Name (Legal Business Name): LARELL THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2336 PLAZA DEL AMO
TORRANCE CA
90501-3419
US

IV. Provider business mailing address

2336 PLAZA DEL AMO
TORRANCE CA
90501-3419
US

V. Phone/Fax

Practice location:
  • Phone: 310-972-6500
  • Fax:
Mailing address:
  • Phone: 310-972-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: