Smith, Jackie
Smith, Jackie is an sole proprietor health care provider with primary practice located at 9100 Brentwood Blvd , Brentwood CA 94513-4000. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Smith, Jackie can be contacted via phone (925) 809-7920.Contact Information
Primary practice address
9100 Brentwood Blvd
Brentwood CA 94513-4000
Phone: (925) 809-7920
Fax: (925) 809-7928
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1154543866 |
|---|---|
| LBN Legal business name | Smith, Jackie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2007 |
| Last updated | Feb 5th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154543866 | NPPES |
| California | Other | 07557 | DMC ADOL BRENTWOOD |
| California | Other | 0726 | DMC ADOL BRENTWOOD |
| California | Other | 56681 | DMC ADOL BRENTWOOD |
| California | Other | 07553 | DMC ADOL BRENTWOOD |
| California | Other | 070726 | DMC ADOL BRENTWOOD |
| California | Other | 070753 | DMC ADOL BRENTWOOD |
| California | Other | 0753 | DMC ADOL BRENTWOOD |
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