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NPI Code Detail

MEDICARE: JENNIFER THOMAS RN

MEDICARE: JENNIFER THOMAS RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse707758CA

General Provider Information

NPI Number : 1144172339
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER THOMAS RN
Provider Business Mailing Address
First Line : 1481 KEARNS RD
Second Line :
City : PLACERVILLE
State : CA
Zip : 95667-9157
Country : US
Telephone Number : 925-640-0326
Fax Number :
Provider Business Practice Location Address
First Line : 4212 MISSOURI FLAT RD
Second Line :
City : PLACERVILLE
State : CA
Zip : 95667-6269
Country : US
Telephone Number : 530-621-7700
Fax Number : 530-621-7713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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