Provider Demographics
NPI:1336305234
Name:THOMAS, YVONNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11726 SAN VICENTE BLVD STE 680
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5049
Mailing Address - Country:US
Mailing Address - Phone:310-826-4571
Mailing Address - Fax:
Practice Address - Street 1:11726 SAN VICENTE BLVD STE 680
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5049
Practice Address - Country:US
Practice Address - Phone:310-826-4571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 14489103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical