Healthcare Provider Details

I. General information

NPI: 1285561217
Provider Name (Legal Business Name): GLORI ANN SMILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2458 N FILLMORE AVE
RIALTO CA
92377-4214
US

IV. Provider business mailing address

PO BOX 1578
RUNNING SPRINGS CA
92382-1578
US

V. Phone/Fax

Practice location:
  • Phone: 909-659-9267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: