Healthcare Provider Details

I. General information

NPI: 1508900929
Provider Name (Legal Business Name): ASHLEY JANINE SMITH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2007
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 VAN BEURDEN DR STE 101
LOS OSOS CA
93402-3384
US

IV. Provider business mailing address

PO BOX 626
KERNVILLE CA
93238-0626
US

V. Phone/Fax

Practice location:
  • Phone: 805-391-0829
  • Fax:
Mailing address:
  • Phone: 805-391-0829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT83951
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT83951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: