Healthcare Provider Details

I. General information

NPI: 1437334471
Provider Name (Legal Business Name): LINDA SMITH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 HUGHES WAY
LONG BEACH CA
90810-1870
US

IV. Provider business mailing address

3125 E 7TH ST
LONG BEACH CA
90804-4932
US

V. Phone/Fax

Practice location:
  • Phone: 323-489-5835
  • Fax:
Mailing address:
  • Phone: 562-439-7755
  • Fax: 562-438-6891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number313832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: