Healthcare Provider Details

I. General information

NPI: 1013053925
Provider Name (Legal Business Name): JODI SMITH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MYRTLE AVE
EUREKA CA
95501-1219
US

IV. Provider business mailing address

901 MYRTLE AVE
EUREKA CA
95501-1219
US

V. Phone/Fax

Practice location:
  • Phone: 707-502-4752
  • Fax:
Mailing address:
  • Phone: 707-502-4752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 49643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: