Provider Demographics
NPI:1689190159
Name:THOMAS, SHEILA L (PSY D)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E SHAW AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7903
Mailing Address - Country:US
Mailing Address - Phone:559-712-8800
Mailing Address - Fax:559-712-8805
Practice Address - Street 1:1300 E SHAW AVE STE 109
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7903
Practice Address - Country:US
Practice Address - Phone:559-712-8800
Practice Address - Fax:559-712-8805
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
CA31752103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor