Individual provider Active NPI

Charles Thomas

  • Psychiatry Physician
  • Ventura, CA
National Provider Identifier
1760603161
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A63126 Issued in CA
Practice address
3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone
(805) 652-6556
NPI assigned
May 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Psychiatry Physician 2084P0800X A63126 CA Primary

Addresses

Primary practice location

3291 Loma Vista Rd
Ventura, CA 93003-3099

Mailing address

3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone (805) 652-6556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091228000473 CA Practitioner - Psychiatry 2668512542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Ohio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

2100 Napa Vallejo Hwy
Napa, CA 94558-6234
Phone (916) 651-8811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A63126CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Mar 9, 2015 Accepting new patients
Department of State Hospitals CurrentSince Mar 9, 2015 Accepting new patients

Locations

2100 Napa Vallejo Hwy
Napa, CA 94558
Phone (707) 253-5000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

Organizations & group practices 3

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760603161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-652-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-652-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A63126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.