Healthcare Provider Details

I. General information

NPI: 1689318834
Provider Name (Legal Business Name): RACHEL THOMAS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 ASHTON AVE STE 200
MANASSAS VA
20109-5701
US

IV. Provider business mailing address

1950 S SUNWEST LN STE 200
SAN BERNARDINO CA
92408-3248
US

V. Phone/Fax

Practice location:
  • Phone: 703-330-9933
  • Fax: 703-686-4319
Mailing address:
  • Phone: 909-252-4017
  • Fax: 909-252-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810008880
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: