MEDICARE: JESSICA LORRAINE 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
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1194659342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LORRAINE SMITH

Provider Business Mailing Address
First Line	:	780 POST ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6177
Country	:	US
Telephone Number	:	949-330-9240
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 POST ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6177
Country	:	US
Telephone Number	:	949-330-9240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ JESSICA LORRAINE SMITH ” Practice Location

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