Judith Selfridge Thomas, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP7106 Issued in CA

Practice address

1300 W 7TH St
San Pedro, CA 90732-3505

Phone

(310) 514-5350

Fax

(310) 514-5421

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1679501597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 PACIFIC COAST HWY",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930019718",
            "telephone_number": "805-641-3483",
            "fax_number": "805-641-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-514-5350",
            "fax_number": "310-514-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JUDITH",
        "middle_name": "SELFRIDGE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP7106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN262576",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Beacon House Association of San Pedro (Beacon House)
• The Eminence Group
• The Guidance Center
• The Healing & Hope Foundation
• The San Pedro Clinic
• Thrifty Payless Inc (Rite Aid Pharmacy 05514)
• Thrifty Payless Inc (Rite Aid Pharmacy 05513)
• Lynda Carraway Tillman, M.A.
• Gina Titus
• Carie Kay Tol

• Nurse Practitioner in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.