NPI 1184959173

Collis Smith

Practitioner Licensed Psychiatric Technician San Bernardino, CA

Practice location

Address: 2080 S E St, San Bernardino, CA 92408-2706
Phone: (909) 825-8989
Mailing address: 11650 Cherry Ave, Fontana, CA 92337-2786

Registered specialties

Licensed Psychiatric Technician Primary

Nursing Service Providers Taxonomy 167G00000X Licence 34214 (CA)

Other Licensed Psychiatric Technician providers in California →

Registry record

NPI: 1184959173
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Oct 2009
Record last updated: 8 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.