Healthcare Provider Details

I. General information

NPI: 1356700975
Provider Name (Legal Business Name): LATOYA ELAINE SMITH ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST # 07128 SPINAL CORD INJURY HEALTHCARE GROUP
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

5901 E 7TH ST # 07128 SPINAL CORD INJURY HEALTHCARE GROUP
LONG BEACH CA
90822-5201
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax:
Mailing address:
  • Phone: 562-826-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number4120
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number4120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: