Individual
WILL KEOLA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
8737 VENICE BLVD STE 201, LOS ANGELES, CA 90034-3258
(510) 545-9825
(617) 491-2070
Mailing address
8737 VENICE BLVD STE 201, LOS ANGELES, CA 90034-3258
(510) 545-9825
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95115428
CA
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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