Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeremy Stephen Thacker

Individual provider Clinical Psychologist · NPI 1508661794

Jeremy Stephen Thacker is a Clinical Psychologist in Studio City, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

11712 Moorpark St Ste 204B
Studio City, CA 91604-2158
Phone: (323) 834-2420
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSB94027985 (CA)

Record details

NPI number1508661794
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 13, 2025
Last updated in NPPESFebruary 13, 2025
Certification dateFebruary 13, 2025
Mailing address11712 Moorpark St Ste 204b, Studio City, CA 91604-2158

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