Jennie Lorena Thomas, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSB94022230 Issued in CA

Practice address

11344 Coloma Rd Ste 605
Gold River, CA 95670-4463

Phone

(916) 599-9668

Fax

(888) 374-0652

NPI assigned

Sep 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Jimmie Lorenzo Thomas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Authentic Counseling Associates - a Psychological Corporation

  • Psychologist
  • Gold River, CA
  • NPI 1003165846
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1952596025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11344 COLOMA RD STE 605",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704463",
            "telephone_number": "916-599-9668",
            "fax_number": "888-374-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11344 COLOMA RD STE 605",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704463",
            "telephone_number": "916-599-9668",
            "fax_number": "888-374-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JENNIE",
        "middle_name": "LORENA",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "00056469",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94022230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIMMIE",
            "last_name": "THOMAS",
            "middle_name": "LORENZO",
            "prefix": "MR.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madeline Stein
• Sandra Stemple, PHD, LCSW
• Diana Sundukos, LCSW
• Aviree Lauren Tate
• Anika Thielbar
• Emma Todd
• Margrette Elaine Townsend, PSB94023890
• Jolene Marie Traud, LMFT
• Julia Elizabeth Treland, PH.D.
• True Comfort Home Health

• Clinical Psychologist in Gold River, CA
• Providers in Gold River, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.