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General NPI Number Information
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NPI Number | 1154816981
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Entity Type | Individual
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Provider Name | KORINNE MARIE SMITH
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Gender | Female
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 5201 GREAT AMERICA PKWY STE 320
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City | SANTA CLARA
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State | CA
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Zip | 95054-1140
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Country | US
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Telephone | 323-205-7088
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Fax |
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Provider Business Mailing Address
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Address Line | 7560 KEMPSTER CT
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City | FONTANA
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State | CA
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Zip | 92336-2174
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Country | US
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Telephone | 909-827-8697
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 121907
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License Number State | CA
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