KEONDRE DEJAWN THOMAS


Address: 2772 S Martin Luther King Blvd, Fresno, CA 93727
Phone: 5592654800

KEONDRE DEJAWN THOMAS (NPI# 1407400856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407400856
Entity Type Individual
Full Name KEONDRE DEJAWN THOMAS
Practice Address 2772 S Martin Luther King Blvd
Fresno
CA 93727
Mailing Address 2772 S Martin Luther King Blvd
Fresno
CA 93706
Practice Telephone 5592654800
Enumeration Date 2019-07-24
Last Update Date 2019-07-24
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 2772 S MARTIN LUTHER KING BLVD
City FRESNO
State CA
Zip Code 93727

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457571077 Monique Maria Villareal Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2007-04-26
1194349175 Arthur Portillo Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2020-06-04
1770118069 Armando Enepomuceno Garcia Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2020-03-06
1700419306 Maricela Velasquez Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2020-02-21
1891326229 Joe Anthony Gaeta Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2020-02-04
1144868894 Rosemary Alica Musquez Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2019-12-12
1518503440 Michael Jimenez Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2019-11-26
1053957365 Roy Perez Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2019-11-21
1376185033 Leslie Ann Posey Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706 2019-10-15
1679127955 Angela M Romero Counselor 2772 S Martin Luther King Blvd, Fresno, CA 93706-1225 2019-07-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1427524354 Travis L Minor Driver 4573 Kings Canyon Rd, Freso, CA 93727 2018-10-18
1780178921 Amanda Hernandez Behavior Technician 6358 E Mono St, Fresno, CA 93727 2018-06-20
1225533169 Lindsay Fisher Marriage & Family Therapist 4928 E Clinton Way Ste 108, Fresno, CA 93727 2018-03-23
1811351992 Paulinder Ranu Pediatrics 5557 E King Cyn Rd, Fresno, CA 93727 2016-04-05
1851781371 Sheri Taylor Social Worker 2010 N Fine Ave # 105, Fresno, CA 93727 2015-02-04
1770917486 Elouise Jones-green Counselor 4491 E. Mckinley Ave #112, Fresno, CA 93727 2013-08-29
1700227022 Chee Vang Counselor 4855 E Kings Canyon Rd Ste 105, Fresno, CA 93727 2013-07-15
1578839791 Garfield Beach Cvs LLC Durable Medical Equipment & Medical Supplies 5995 E Kings Canyon Rd, Fresno, CA 93727 2012-04-02
1932411378 Leticia Ball Marriage & Family Therapist 4944 E. Clinton Way, Fresno, CA 93727 2010-07-13
1639308158 Juanita Sermeno Counselor 4944 E. Clinton, Suite 101, Fresno, CA 93727 2009-07-06
Find all providers in zip 93727

Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164022976 Denise Renee Hands Counselor 4604 E Terrace Ave, Fresno, CA 93703-2079 2020-10-30
1649807694 Debbie Jeneen Darden Counselor 891 W Kearney Blvd, Fresno, CA 93706-2514 2020-03-26
1205466802 Elizabeth C Esqueda Counselor 804 S Parallel Ave, Fresno, CA 93721-2404 2020-01-22
1295378446 Caussaundra Maria Dominguez Counselor 2772 S Martin Luther King, Fresno, CA 93706 2019-10-21
1881244945 Aurelio Mendoza Counselor 1414 W. Kearney Blvd, Fresno, CA 93706 2019-09-19
1356994909 Joaquin Sanchez Counselor Quest House 2731 W Olive Ave, Fresno, CA 93728 2019-07-23
1003374539 Jasmine Elizabeth Flores Counselor 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 2019-03-04
1104397348 Brian K Bradley Counselor 2212 N Winery Ave, Fresno, CA 93703-2896 2018-12-16
1063982049 Bruno Sivongxay Counselor 2772 South Martin L King Jr Blvd, Fresno, CA 93706 2018-12-03
1831669951 Ashlee Faith Vasquez Counselor 1900 N Gateway Blvd Ste 100, Fresno, CA 93727-1622 2018-12-01
Find all providers in FRESNO

Competitor

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City FRESNO
Zip Code 93727

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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