Individual
STACEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
836 E 74TH ST, LOS ANGELES, CA 90001-2312
(323) 385-8298
Mailing address
836 E 74TH ST, LOS ANGELES, CA 90001-2312
(323) 385-8298
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
198603591
CA
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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