Individual
KENISHA DENISE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12021 WILMINGTON AVE STE 300, LOS ANGELES, CA 90059-3019
(424) 529-6755
Mailing address
205 N SANTA FE AVE, COMPTON, CA 90221-2730
(562) 580-8224
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
374700000X
Technician
Primary
—
—
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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