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General NPI Number Information
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NPI Number | 1275448474
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Entity Type | Individual
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Provider Name | SAMMANTHA A SMITH
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Gender | Female
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 3689 RIDGE LINE DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4176
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Country | US
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Telephone | 626-383-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 3689 RIDGE LINE DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4176
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Country | US
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Telephone |
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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 | 2278E0002X
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Taxonomy Name | Emergency Care Certified Respiratory Therapist
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License Number | 48430
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number | 48430
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2278S1500X
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Taxonomy Name | SNF/Subacute Care Certified Respiratory Therapist
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License Number | 48430
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2279G1100X
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Taxonomy Name | General Care Registered Respiratory Therapist
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License Number | 48430
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License Number State | CA
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