Healthcare Provider Details

I. General information

NPI: 1508762964
Provider Name (Legal Business Name): VIRGINIA SMITH THOMAS DNP, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIRGINIA SMITH

II. Dates (important events)

Enumeration Date: 10/14/2026
Last Update Date: 10/14/2026
Certification Date: 10/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42135 10TH ST W
LANCASTER CA
93534-7095
US

IV. Provider business mailing address

23808 SPINNAKER CT
SANTA CLARITA CA
91355-1601
US

V. Phone/Fax

Practice location:
  • Phone: 661-341-3800
  • Fax:
Mailing address:
  • Phone: 917-293-6503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035944
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: