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General NPI Number Information
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NPI Number | 1437689338
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Entity Type | Individual
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Provider Name | KRYSTAL SMITH PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1818 S STATE COLLEGE BLVD UNIT 321
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City | ANAHEIM
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State | CA
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Zip | 92806-8913
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Country | US
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Telephone | 775-298-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 STEAMBOAT PKWY UNIT 7105
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City | RENO
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State | NV
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Zip | 89521-6373
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Country | US
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Telephone | 248-885-9027
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY34381
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY1151
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License Number State | NV
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