Individual
LIJON ANTOINETTE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 EDMONDS RD., BUILDING D, REDWOOD CITY, CA 94062-3813
(310) 221-6336
Mailing address
240 EDMONDS RD., BUILDING D, REDWOOD CITY, CA 94062-3813
(310) 221-6336
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41513
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41513
CORDILLERAS MHRC
CA
Enumeration date
12/03/2021
Last updated
08/26/2024
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