Healthcare Provider Details

I. General information

NPI: 1669348348
Provider Name (Legal Business Name): FOXIE M.A. SMITH-THOMPSON
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: MALIK A SMITH-THOMPSON

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HUGHES WAY
LONG BEACH CA
90810-1865
US

IV. Provider business mailing address

1515 HUGHES WAY
LONG BEACH CA
90810-1865
US

V. Phone/Fax

Practice location:
  • Phone: 562-997-8000
  • Fax:
Mailing address:
  • Phone: 562-997-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: