Healthcare Provider Details

I. General information

NPI: 1720078868
Provider Name (Legal Business Name): MICHELLE MARIE YOUNT-SMETANA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41750 RANCHO LAS PALMAS DR SUITE L6
RANCHO MIRAGE CA
92270-5511
US

IV. Provider business mailing address

41750 RANCHO LAS PALMAS DR SUITE L6
RANCHO MIRAGE CA
92270-5511
US

V. Phone/Fax

Practice location:
  • Phone: 760-674-9100
  • Fax: 760-674-9211
Mailing address:
  • Phone: 760-674-9100
  • Fax: 760-674-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY20432
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY20432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: