Provider Demographics
NPI:1861148959
Name:THOMAS, ADRIAN ALEXANDER (OTR/L)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:ALEXANDER
Last Name:THOMAS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26292 TIGER LILLY AVE
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6441
Mailing Address - Country:US
Mailing Address - Phone:909-569-8729
Mailing Address - Fax:
Practice Address - Street 1:27350 NICOLAS RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-7349
Practice Address - Country:US
Practice Address - Phone:951-308-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-27
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21306225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist