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NPI Code Detail

MEDICARE: JASON R SMITH RN/DON

MEDICARE: JASON R SMITH RN/DON
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
1163WA2000XAdministrator Registered Nurse95398381CA

General Provider Information

NPI Number : 1205787736
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON R SMITH RN/DON
Provider Business Mailing Address
First Line : 1532 ROSALIND ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-4535
Country : US
Telephone Number : 916-584-1205
Fax Number :
Provider Business Practice Location Address
First Line : 1532 ROSALIND ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-4535
Country : US
Telephone Number : 916-584-1205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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