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Tolya Lashawn Thompson

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1 Medical Plaza Dr, Roseville, CA 95661-3037

PECOS Enrollment

This provider is enrolled in PECOS as TOLYA THOMPSON.

Based on the most recent information from CMS, provider Tolya Lashawn Thompson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1154343622
Provider Type
Individual
Full Name
Thompson, Tolya Lashawn
Credential
P.A-C

Gender
Female
Sole Proprietor
No
Enumeration Date
7/24/2006
Last Updated
11/13/2007

Contact Information

Practice Location

1 Medical Plaza Dr, Roseville, CA 95661-3037

(916) 781-1000

Unlisted Fax

Mailing Location

2100 Powell St, Ste 900, Emeryville, CA 94608-1826

(510) 350-2600

(510) 879-9100

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA17183 California

Tolya Lashawn Thompson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Blecher, Marcia

Samuels, Jason

Peterson, Bart J

Miranda, Lisa M

Reyes, Florita

Sachs, Lorne

Vue, Jessica

Brekke, Chelsea Marie

Nugent, Christopher P

Sievers, Kelsie Lois