Healthcare Provider Details

I. General information

NPI: 1770439564
Provider Name (Legal Business Name): SYBIL SMITH PPS SCHOOL PSYCHOLOG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S ACACIA AVE
COMPTON CA
90220-3702
US

IV. Provider business mailing address

1065 SW 8TH ST STE 5467
MIAMI FL
33130-3601
US

V. Phone/Fax

Practice location:
  • Phone: 559-250-6393
  • Fax:
Mailing address:
  • Phone: 559-250-6393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: