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NPI Code Detail

MEDICARE: ALICIA SMITH

MEDICARE: ALICIA 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
1103K00000XBehavior Analyst1-15-18402CA

General Provider Information

NPI Number : 1710265228
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA SMITH
Provider Business Mailing Address
First Line : 685 E CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91106-3847
Country : US
Telephone Number : 626-795-7910
Fax Number :
Provider Business Practice Location Address
First Line : 4688 ONTARIO MILLS PKWY
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5104
Country : US
Telephone Number : 909-476-5747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2011
Last Update Date : 08/02/2023

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Directions to “ ALICIA SMITH ” Practice Location

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