Healthcare Provider Details

I. General information

NPI: 1235701756
Provider Name (Legal Business Name): ARTEJA LYNN RISING SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 07/14/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 NAPPY VALLEY CORPORATE DRIVE, BLDG. B
NAPA CA
94558
US

IV. Provider business mailing address

1409 H ST APT 1
DAVIS CA
95616-1120
US

V. Phone/Fax

Practice location:
  • Phone: 707-210-2437
  • Fax:
Mailing address:
  • Phone: 707-927-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: