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General NPI Number Information
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NPI Number | 1841158433
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Entity Type | Individual
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Provider Name | TREY JACOB KAHOKU THOMAS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 3333 CONCOURS STE 4102
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City | ONTARIO
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State | CA
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Zip | 91764-6564
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Country | US
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Telephone | 909-240-1764
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Fax | 909-259-2369
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Provider Business Mailing Address
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Address Line | 12283 PACOIMA RD
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City | VICTORVILLE
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State | CA
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Zip | 92392-9600
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Country | US
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Telephone | 760-881-7435
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CA
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