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General NPI Number Information
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NPI Number | 1467842401
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Entity Type | Organization
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Legal Business Name | P. JEAN SMITH LMFT
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 204 N FLORAL ST SUITE A
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City | VISALIA
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State | CA
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Zip | 93291-4957
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Country | US
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Telephone | 559-406-9761
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Fax | 484-906-1676
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Provider Business Mailing Address
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Address Line | 204 N FLORAL ST SUITE A
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City | VISALIA
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State | CA
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Zip | 93291-4957
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Country | US
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Telephone | 559-406-9761
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Fax | 484-906-1676
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | PHILLIPA JEAN SMITH
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Credential | SOLE PROPRIETOR
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Telephone | 559-859-1911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 7
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC45288
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License Number State | CA
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