Healthcare Provider Details

I. General information

NPI: 1588798680
Provider Name (Legal Business Name): KELLY KATHLEEN MOREHOUSE SMITH M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27272 ROSEMONT LN
VALENCIA CA
91354-2126
US

IV. Provider business mailing address

23890 COPPER HILL DR # 707
VALENCIA CA
91354-1701
US

V. Phone/Fax

Practice location:
  • Phone: 747-224-1422
  • Fax:
Mailing address:
  • Phone: 747-224-1422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT45929
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: