Provider Demographics
NPI:1528601457
Name:THOMAS, DEEPA (SLP, AAC)
Entity Type:Individual
Prefix:MRS
First Name:DEEPA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:SLP, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 S SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-1375
Mailing Address - Country:US
Mailing Address - Phone:408-476-3237
Mailing Address - Fax:
Practice Address - Street 1:978 S SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95391-1375
Practice Address - Country:US
Practice Address - Phone:408-476-3237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist