COLLIS SMITH NPI 1184959173

NPI Information

Collis Smith is a licensed psychiatric technician in San Bernardino, CA. The provider is an individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. Collis Smith NPI is 1184959173. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2080 S E ST
SAN BERNARDINO, CA
ZIP 92408-706
Phone: (909) 825-8989

The enumeration date for this NPI number is 10/8/2009 and was last updated on 10/8/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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