Provider Demographics
NPI:1093698458
Name:THOMAS, CEDRIC MAURICE JR
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:MAURICE
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 TARA CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2726
Mailing Address - Country:US
Mailing Address - Phone:661-433-8271
Mailing Address - Fax:
Practice Address - Street 1:1628 TARA CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-2726
Practice Address - Country:US
Practice Address - Phone:661-433-8271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7510003548374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide