Individual provider Active NPI

Sandra S. Thomas, PH.D.

  • Clinical Social Worker
  • Grover Beach, CA
National Provider Identifier
1043239064
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS12113 Issued in CA
Practice address
160 N 7TH St
Suite a
Grover Beach, CA 93433-2070
Phone
(805) 473-1543
Fax
(805) 473-1543
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS12113 CA Primary

Addresses

Primary practice location

160 N 7TH St
Suite a
Grover Beach, CA 93433-2070

Mailing address

160 N 7TH St
Suite a
Grover Beach, CA 93433-2070
Phone (805) 473-1543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000592 CA Practitioner - Clinical Social Worker 3173589215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12113CAMDMental Health Counselor
LCS12113CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin Parzych a Medical Corp Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043239064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N 7TH ST",
            "address_2": "SUITE A",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332070",
            "telephone_number": "805-473-1543",
            "fax_number": "805-473-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N 7TH ST",
            "address_2": "SUITE A",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332070",
            "telephone_number": "805-473-1543",
            "fax_number": "805-473-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SANDRA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS12113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grover Beach, CA

Sources for this page

Verify at the official NPI Registry.