Healthcare Provider Details

I. General information

NPI: 1316327844
Provider Name (Legal Business Name): ROCHELLE KRISTINA SMITH MS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2772 S MARTIN LUTHER KING JR. BLVD
FRESNO CA
93706
US

IV. Provider business mailing address

558 W TWAIN AVE
CLOVIS CA
93612-2349
US

V. Phone/Fax

Practice location:
  • Phone: 559-241-9957
  • Fax:
Mailing address:
  • Phone: 559-241-9957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number94178
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number94178
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: