MEDICARE: YVONNE L. THOMAS, PH.D.

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1912252479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YVONNE L. THOMAS, PH.D.

Provider Business Mailing Address
First Line	:	11726 SAN VICENTE BLVD STE 680
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11726 SAN VICENTE BLVD STE 680
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5049
Country	:	US
Telephone Number	:	310-726-3944
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST/OWNER
Name	:	DR. YVONNE L. THOMAS
Credential	:
Telephone Number	:	310-726-3944

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	07/19/2012

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