Provider Demographics
NPI:1891518023
Name:THOMAS, ESTHER LORRAINE
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:LORRAINE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:761 PINE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-7153
Mailing Address - Country:US
Mailing Address - Phone:951-551-4014
Mailing Address - Fax:
Practice Address - Street 1:473 S CARNEGIE DR
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-4207
Practice Address - Country:US
Practice Address - Phone:909-565-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1254851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical