Wanda Elaine Smith, ADMINISTRATOR

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

197602356 Issued in CA

Practice address

1046 E Lancaster Blvd
Lancaster, CA 93535-2752

Phone

(661) 992-6371

Fax

(855) 631-0360

NPI assigned

Dec 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A.N.a Residential Care

  • Assisted Living Facility
  • Lancaster, CA
  • NPI 1245906627
  NPD Authorized official
• A.N.a Residential Care LLC

  • Assisted Living Facility
  • Lancaster, CA
  • NPI 1326579483
  NPD Authorized official

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1083045496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 E. LANCASTER BLVD",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93535",
            "telephone_number": "661-992-6371",
            "fax_number": "855-631-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 E LANCASTER BLVD",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935352752",
            "telephone_number": "661-992-6371",
            "fax_number": "855-631-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WANDA",
        "middle_name": "ELAINE",
        "name_prefix": "Miss",
        "credential": "ADMINISTRATOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197602356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantanece Smith
• Stephanie N Smith
• Stevie Lee Smith, RDHAP, MPH
• Tony Lee Smith, DC, QME
• Tyanna Smith
• Shaleechia Chanell Sneed, LCSW
• Snow Lancaster Dental Office
• Sheryl Diane Snow, M.ED., CADC-II, LMFT
• Jaime Snyder, MD
• So Lighthouse LLC

• Assisted Living Facility in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.