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General NPI Number Information
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NPI Number | 1750845533
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Entity Type | Individual
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Provider Name | DAVID LEONARD SMITH LMFT, LPCC, PHD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2019
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 4145 LA SIERRA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92505-2938
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Country | US
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Telephone | 323-547-4545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 172
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City | JURUPA VALLEY
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State | CA
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Zip | 91752-0172
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Country | US
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Telephone | 323-547-4545
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC12852
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT134932
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License Number State | CA
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