Provider Demographics
NPI:1689150070
Name:RESHALE L THOMAS, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:RESHALE L THOMAS, A PSYCHOLOGICAL CORPORATION
Other - Org Name:ALLAY PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RESHALE
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:559-721-2960
Mailing Address - Street 1:710 VAN NESS AVE # 198
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-2912
Mailing Address - Country:US
Mailing Address - Phone:559-721-2960
Mailing Address - Fax:
Practice Address - Street 1:2900 FRESNO ST STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1439
Practice Address - Country:US
Practice Address - Phone:559-721-2960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY30016261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)