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General NPI Number Information
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NPI Number | 1043928245
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Entity Type | Individual
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Provider Name | VANESSA RENEE SMITH CONSTANTINO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 6926 BROCKTON AVE STE 8
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City | RIVERSIDE
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State | CA
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Zip | 92506-3804
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Country | US
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Telephone | 877-414-7739
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Fax | 844-682-0372
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Provider Business Mailing Address
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Address Line | 14065 MOONRIDGE DR
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City | RIVERSIDE
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State | CA
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Zip | 92503-9700
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Country | US
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Telephone | 951-315-5126
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95011060
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License Number State | CA
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