Keondre Dejawn Thomas

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2772 S Martin Luther King Blvd
Fresno, CA 93727

Phone

(559) 265-4800

NPI assigned

Jul 24, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1407400856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 S MARTIN LUTHER KING BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 S MARTIN LUTHER KING BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93727",
            "telephone_number": "559-265-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KEONDRE",
        "middle_name": "DEJAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Kendall Thomas, B.S.
• Jayden Thomas
• Jeffery David Thomas, LMFT
• Jeffrey Thomas, M.D.
• Jonnetta Marie Thomas
• Michael Thomas
• Michelle A Thomas, M.D.
• Mikhaila Thomas
• Nikki C Thomas, LMFT
• Reshale L Thomas, PSYD

• Addiction (Substance Use Disorder) Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.