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General NPI Number Information
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NPI Number | 1588445381
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Entity Type | Individual
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Provider Name | ALYSSA MARIE SMITH
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Gender | Female
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 874 PLUMAS ST STE C
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City | YUBA CITY
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State | CA
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Zip | 95991-4023
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Country | US
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Telephone | 530-443-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 2066 HOWLETT AVE APT F
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City | YUBA CITY
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State | CA
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Zip | 95993-9677
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Country | US
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Telephone | 530-599-2572
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | F7506305
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License Number State | CA
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