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General NPI Number Information
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NPI Number | 1689150070
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Entity Type | Organization
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Legal Business Name | RESHALE L THOMAS, A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 2900 FRESNO ST STE 108
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City | FRESNO
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State | CA
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Zip | 93721-1439
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Country | US
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Telephone | 559-721-2960
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Fax |
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Provider Business Mailing Address
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Address Line | 710 VAN NESS AVE # 198
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City | FRESNO
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State | CA
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Zip | 93721-2912
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Country | US
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Telephone | 559-721-2960
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED PSYCHOLOGIST
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Name | DR. RESHALE L THOMAS
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Credential | PSYD
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Telephone | 559-721-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PSY30016
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License Number State | CA
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