Andrea Nicole Smith

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT101028 Issued in CA

Practice address

780 E Gilbert St
San Bernardino, CA 92415-1003

Phone

(909) 387-7194

NPI assigned

Apr 18, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1063856201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151003",
            "telephone_number": "909-387-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151003",
            "telephone_number": "909-387-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF81751",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT101028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Michelle Smirl, NP
• Donna Smith-Burgess, MFT
• Amanda Jasmine Smith, AMFT
• Amanda Marie Smith
• Amesha Corine Smith, BCBA
• Aneesa Smith
• Angela Smith
• April Michelle Smith
• Brant Dean Smith, MFTI
• Brea Trinity Smith, PNP

• Marriage & Family Therapist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.