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NPI Code Detail

MEDICARE: CHRISTOPHER J THOMAS MA, LMFT 105670

MEDICARE: CHRISTOPHER J THOMAS MA, LMFT 105670
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 Therapist105670CA

General Provider Information

NPI Number : 1720556723
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER J THOMAS MA, LMFT 105670
Provider Business Mailing Address
First Line : 4165 PEPPER DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92105-4554
Country : US
Telephone Number : 619-517-0026
Fax Number :
Provider Business Practice Location Address
First Line : 2851 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3814
Country : US
Telephone Number : 619-517-0026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2018
Last Update Date : 11/07/2018

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