Provider Demographics
NPI:1386360964
Name:THOM, ADELA CRISTINA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ADELA
Middle Name:CRISTINA
Last Name:THOM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:685 MORRO AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442-2233
Mailing Address - Country:US
Mailing Address - Phone:805-772-7313
Mailing Address - Fax:805-772-0395
Practice Address - Street 1:685 MORRO AVE STE C
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-2233
Practice Address - Country:US
Practice Address - Phone:805-772-7313
Practice Address - Fax:805-772-0395
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95023015363LF0000X
CA335217163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice