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General NPI Number Information
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NPI Number | 1013670645
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Entity Type | Individual
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Provider Name | BARBARA CONCETTA SMITH RN CCM
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Gender | Female
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 03/22/2026
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Provider Practice Location Address
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Address Line | 200 MERCY CIRCLE DR
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City | CAMP PENDLETON
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State | CA
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Zip | 92055
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Country | US
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Telephone | 760-454-7228
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Fax |
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Provider Business Mailing Address
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Address Line | 2960 EMERALD PL
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City | CARLSBAD
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State | CA
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Zip | 92009-4412
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Country | US
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Telephone | 760-696-2666
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 350967
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License Number State | CA
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