Individual
MR. JEFFERY EARL THOMAS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC,LAADC
Contact information
Practice address
503 OCEAN FRONT WALK, VENICE, CA 90291-2403
(310) 392-3070
(310) 557-8989
Mailing address
503 OCEAN FRONT WALK, VENICE, CA 90291-2403
(310) 392-3070
(310) 557-8989
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCC17264
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CATC NO. 156320 III
ADDICTION CERTIFICATION BOARD OF CALIFORNIA
CA
01
—
LR10050821
LICENSED ADVANCED ALCOHOL ADDICTION COUNSELOR
CA
01
—
T0912071404
REGISTERED ADDICTION SPECIALIST
CA
Enumeration date
05/28/2013
Last updated
12/20/2024
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