Healthcare Provider Details

I. General information

NPI: 1326656984
Provider Name (Legal Business Name): CADENA LEE SMART FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CADENA LEE WOOD

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MABLE AVE, SUITE 2
MODESTO CA
95355-1120
US

IV. Provider business mailing address

1300 MABLE AVE SUITE 2 CENTRAL VALLEY PAIN MANAGEMENT
MODESTO CA
95355-1120
US

V. Phone/Fax

Practice location:
  • Phone: 209-571-1992
  • Fax: 209-571-1994
Mailing address:
  • Phone: 209-571-1992
  • Fax: 209-571-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95019166
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number95019166
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: