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General NPI Number Information
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NPI Number | 1255667770
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Entity Type | Individual
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Provider Name | HEATHER ELIZABETH THOMAS LMFT MFC 52806
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Gender | Female
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 3294 ROYAL DR SUITE 201A
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City | CAMERON PARK
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State | CA
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Zip | 95682-8534
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Country | US
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Telephone | 805-234-2834
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Fax | 888-519-3159
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Provider Business Mailing Address
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Address Line | 3450 PALMER DRIVE SUITE 4 257
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City | CAMERON PARK
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State | CA
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Zip | 95682
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Country | US
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Telephone | 805-234-2834
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Fax | 888-519-3159
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF61360
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 52806
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License Number State | CA
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