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NPI Code Detail

MEDICARE: CHEYENNE SMITH

MEDICARE: CHEYENNE 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
1372600000XAdult Companion

General Provider Information

NPI Number : 1538030945
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHEYENNE SMITH
Provider Business Mailing Address
First Line : 3161 DWIGHT RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-6456
Country : US
Telephone Number :
Fax Number : 916-427-7122
Provider Business Practice Location Address
First Line : 3161 DWIGHT RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-6456
Country : US
Telephone Number : 916-427-7141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2025
Last Update Date : 06/15/2026

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Directions to “ CHEYENNE SMITH ” Practice Location

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