| Doctor Name: | JENNIFER LYNN SMITH |
| NPI Number: | 1063766186 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 4610 Santa Anita Ave Ste D El Monte, CA - 917311295 |
| Business Phone Number: | 6264533414 |
| Business Fax Number: | 6264533431 |
| Mailing Address: | 179 S Palm Ave Apt 24, UPLAND |
| State: | CA |
| Postal Code: | 917866573 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |