Individual
ISAIAH THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8836 S VERMONT AVE, LOS ANGELES, CA 90044-4832
(310) 751-8612
Mailing address
8836 S VERMONT AVE, LOS ANGELES, CA 90044-4832
(310) 751-8612
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-LDJEZM
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
01/02/2018
Last updated
08/30/2023
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