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NPI Code Detail

MEDICARE: DORIS LA VERNE THOMAS CADPT 10145

MEDICARE: DORIS LA VERNE THOMAS CADPT 10145
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 Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1121504OTHERCA121504

General Provider Information

NPI Number : 1891938510
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORIS LA VERNE THOMAS CADPT 10145
Provider Business Mailing Address
First Line : 500 E 97TH ST APT 2
Second Line :
City : INGLEWOOD
State : CA
Zip : 90301-4250
Country : US
Telephone Number : 310-921-0998
Fax Number :
Provider Business Practice Location Address
First Line : 11227 VALLEY BLVD
Second Line :
City : EL MONTE
State : CA
Zip : 91731-3299
Country : US
Telephone Number : 626-444-0704
Fax Number : 626-246-3046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2009
Last Update Date : 05/04/2020

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Directions to “ DORIS LA VERNE THOMAS CADPT 10145” Practice Location

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