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General NPI Number Information
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NPI Number | 1427171024
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Entity Type | Individual
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Provider Name | JOHN CHARLES THOMAS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 650 UNIVERSITY AVE STE 115
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City | SACRAMENTO
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State | CA
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Zip | 95825-6726
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Country | US
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Telephone | 916-216-1186
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Fax | 916-914-2215
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Provider Business Mailing Address
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Address Line | 2443 FAIR OAKS BLVD # 185
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City | SACRAMENTO
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State | CA
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Zip | 95825-7684
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Country | US
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Telephone | 916-216-1186
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Fax | 916-914-2215
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY14107
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License Number State | CA
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