Provider Demographics
NPI:1003475062
Name:THOMAS, YVONNE MARTINEZ (MS, CADC-III)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:MARTINEZ
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, CADC-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 PROSPECTOR CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-5119
Mailing Address - Country:US
Mailing Address - Phone:916-905-1099
Mailing Address - Fax:
Practice Address - Street 1:130 PROSPECTOR CT
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-5119
Practice Address - Country:US
Practice Address - Phone:916-905-1099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1352340619101YA0400X
CAB00002920423101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)