MEDICARE: DEZTINE K 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	172V00000X	Community Health Worker
2	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639662786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEZTINE K THOMAS

Provider Business Mailing Address
First Line	:	21600 OXNARD ST STE 1800
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7807
Country	:	US
Telephone Number	:	818-345-2345
Fax Number	:

Provider Business Practice Location Address
First Line	:	24910 LAS BRISAS RD STE 117
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-4035
Country	:	US
Telephone Number	:	951-465-3664
Fax Number	:

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

Provider Enumeration Date	:	06/13/2018
Last Update Date	:	02/05/2025

Similar Medicare Providers

1699562249 — MR. DEMETRUS DEAN JONES PMHNP
Practice Location Address:

24910 LAS BRISAS RD STE 117
MURRIETA, CA
92562-4035

Practice Phone: 310-999-1201
Practice Fax:

1114087228 — SINDU PILLAI M.D.
Practice Location Address:

24910 LAS BRISAS RD STE 114
MURRIETA, CA
92562-4035

Practice Phone: 951-600-9093
Practice Fax: 951-600-1132

1124172796 — MURRIETA VALLEY FAMILY MEDICAL GROUP, INC.
Practice Location Address:

24910 LAS BRISAS RD STE 121
MURRIETA, CA
92562-4035

Practice Phone: 951-698-7550
Practice Fax: 951-698-1521

1710256458 — CHRISTINE M. STOVER N.P.
Practice Location Address:

24910 LAS BRISAS RD STE 121
MURRIETA, CA
92562-4035

Practice Phone: 951-698-7550
Practice Fax:

1235649260 — RENEWING HOPE FAMILY COUNSELING CENTER, INC
Practice Location Address:

24910 LAS BRISAS RD STE 117
MURRIETA, CA
92562-4035

Practice Phone: 951-465-3664
Practice Fax: 888-542-4042

1144786443 — JESSICA SALDANA GUZMAN
Practice Location Address:

24910 LAS BRISAS RD STE 117
MURRIETA, CA
92562-4035

Practice Phone: 951-465-3664
Practice Fax:

Directions to “ DEZTINE K THOMAS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.