Healthcare Provider Details

I. General information

NPI: 1861119802
Provider Name (Legal Business Name): TERI LEIGH SMEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RANCHO CAMINO DR FL 2
POMONA CA
91766-7030
US

IV. Provider business mailing address

9572 MAGNOLIA ST
BLOOMINGTON CA
92316-1441
US

V. Phone/Fax

Practice location:
  • Phone: 909-618-0974
  • Fax:
Mailing address:
  • Phone: 909-634-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number106S00000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: