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NPI Code Detail

MEDICARE: BLYTHE ERIN THOMAS

MEDICARE:   BLYTHE ERIN THOMAS
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
1101YM0800XMental Health Counselor149614CA

General Provider Information

NPI Number : 1306663554
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLYTHE ERIN THOMAS
Provider Business Mailing Address
First Line : 2010 EL CAMINO REAL # 202
Second Line :
City : SANTA CLARA
State : CA
Zip : 95050-4051
Country : US
Telephone Number : 408-256-3606
Fax Number :
Provider Business Practice Location Address
First Line : 14583 BIG BASIN WAY STE 2B
Second Line :
City : SARATOGA
State : CA
Zip : 95070-6072
Country : US
Telephone Number : 408-256-3606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2024
Last Update Date : 09/20/2024

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Directions to “ BLYTHE ERIN THOMAS ” Practice Location

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