Individual
DESMOND THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
100 PRISON RD, REPRESA, CA 95671-2501
(916) 985-8610
Mailing address
100 PRISON RD, REPRESA, CA 95671-3000
(916) 985-8610
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY29042
CA
Other
Enumeration date
06/22/2014
Last updated
08/30/2022
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