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NPI Code Detail

MEDICARE: KATRINA SMITH

MEDICARE: KATRINA SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor24622CA

General Provider Information

NPI Number : 1053248286
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA SMITH
Provider Business Mailing Address
First Line : 922 W 81ST ST UNIT 1/4
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-5006
Country : US
Telephone Number : 661-726-2630
Fax Number :
Provider Business Practice Location Address
First Line : 44443 10TH ST W
Second Line :
City : LANCASTER
State : CA
Zip : 93534-3346
Country : US
Telephone Number : 661-726-2630
Fax Number : 661-726-2630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “ KATRINA SMITH ” Practice Location

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