Healthcare Provider Details

I. General information

NPI: 1386194900
Provider Name (Legal Business Name): JACQUELINE SMITH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 16TH ST STE H
BAKERSFIELD CA
93301-5180
US

IV. Provider business mailing address

1731 16TH ST STE H
BAKERSFIELD CA
93301-5180
US

V. Phone/Fax

Practice location:
  • Phone: 661-374-8577
  • Fax:
Mailing address:
  • Phone: 661-374-8577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT130950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: