Provider Demographics
NPI:1770896805
Name:THOMAS, DEBRA ANNETTE
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNETTE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANNETTE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2801 L ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5615
Mailing Address - Country:US
Mailing Address - Phone:916-733-3003
Mailing Address - Fax:
Practice Address - Street 1:2801 L ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5615
Practice Address - Country:US
Practice Address - Phone:916-733-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104446207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine