JACKIE SMITH NPI 1154543866

NPI Information

NPI: 1154543866
Provider Name: JACKIE SMITH
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
9100 BRENTWOOD BLVD
BRENTWOOD, CA
ZIP 94513
Phone: (925) 809-7920
Get Directions

Jackie Smith is an addiction (substance use disorder) counselor in Brentwood, CA. Jackie Smith NPI is 1154543866. 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:

9100 BRENTWOOD BLVD
BRENTWOOD, CA
ZIP 94513-000
Phone: (925) 809-7920
Fax: (925) 809-7928

The enumeration date for this NPI number is 5/3/2007 and was last updated on 2/5/2008.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	07553	OTHER	CALIFORNIA	BRENTWOOD ADOL TX
2	0753	OTHER	CALIFORNIA	DRUG MEDI-CAL BILLING NO
3	0726	OTHER	CALIFORNIA	DRUG M/CAL BILLING NUMBER
4	070753	OTHER	CALIFORNIA	MASTER PROVIDER FILE NUMB
5	070726	OTHER	CALIFORNIA	MASTER PROVIDER NUMBER
6	56681	OTHER	CALIFORNIA	STAFF ID NUMBER
7	07557	OTHER	CALIFORNIA	DMC ADOL BRENTWOOD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »