MEDICARE: JAYDEN 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1356232920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYDEN THOMAS

Provider Business Mailing Address
First Line	:	PO BOX 33568
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-3568
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 E HERNDON AVE STE 105
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2990
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	02/11/2026

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Directions to “ JAYDEN THOMAS ” Practice Location

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