Healthcare Provider Details
I. General information
NPI: 1720135197
Provider Name (Legal Business Name): MRS. SMMION OVERTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/05/2007
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
137 N COTTONWOOD ST
WOODLAND CA
95695
US
IV. Provider business mailing address
137 N. COTTONWOOD ST
WOODLAND CA
95695
US
V. Phone/Fax
- Phone: 530-490-1687
- Fax: 530-666-8633
- Phone: 530-490-1687
- Fax: 530-666-8633
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: