MEDICARE: DR. ALINE SMITH MFT

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	101YM0800X	Mental Health Counselor	MFC22617	CA
2	106H00000X	Marriage & Family Therapist	MFC22617	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366569469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALINE SMITH MFT

Provider Business Mailing Address
First Line	:	PO BOX 372
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-0372
Country	:	US
Telephone Number	:	310-644-3300
Fax Number	:	310-872-5505

Provider Business Practice Location Address
First Line	:	8621 BELLANCA AVE STE 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4432
Country	:	US
Telephone Number	:	310-641-1633
Fax Number	:	310-216-7524

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

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	02/15/2022

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