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General NPI Number Information
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NPI Number | 1619792306
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Entity Type | Individual
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Provider Name | CAMILA BAEZ-SMITH NP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 4440 BROCKTON AVE STE 420
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City | RIVERSIDE
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State | CA
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Zip | 92501-4026
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Country | US
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Telephone | 951-684-8020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | WILMINGTON
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State | CA
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Zip | 90748-0100
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Country | US
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Telephone | 310-944-2426
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95032238
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License Number State | CA
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