Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS 23037 | CA |
NPI | 1003015835 |
---|---|
Provider Name | Ms. Karen Lisa Thomas |
First Address | Oakland, CA 94618-1032 |
Second Address | Oakland, CA 94618-1032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 03/06/2021 |