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NPI Code Detail

MEDICARE: JOLANE THOMAS LMFT

MEDICARE: JOLANE THOMAS LMFT
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
1106H00000XMarriage & Family TherapistMFC37635CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MFC37635OTHERCAMARRIAGE & FAMILY COUNSEL

General Provider Information

NPI Number : 1619035904
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLANE THOMAS LMFT
Provider Business Mailing Address
First Line : 1636 ANITA LN
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-4804
Country : US
Telephone Number : 949-474-8150
Fax Number : 949-650-7638
Provider Business Practice Location Address
First Line : 1000 QUAIL ST
Second Line : SUITE 155
City : NEWPORT BEACH
State : CA
Zip : 92660-2731
Country : US
Telephone Number : 949-474-8150
Fax Number : 949-650-7638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/08/2007

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