Provider Demographics
NPI:1245565639
Name:THOMASY, CLARE NICOLE (OD)
Entity Type:Individual
Prefix:MISS
First Name:CLARE
Middle Name:NICOLE
Last Name:THOMASY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AGOURA CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-2740
Mailing Address - Country:US
Mailing Address - Phone:614-570-5438
Mailing Address - Fax:
Practice Address - Street 1:5 AGOURA CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2740
Practice Address - Country:US
Practice Address - Phone:614-570-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13866152W00000X
OH5903152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist