Terrell Bernard Smith, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

1144714304 Issued in CA

Practice address

25 Allen St
Martinez, CA 94553

Phone

(925) 995-3957

NPI assigned

Jun 20, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1144714304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442408100",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ALLEN ST",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "94553",
            "telephone_number": "925-995-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TERRELL",
        "middle_name": "BERNARD",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.488666",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "1144714304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Smith
• Jeffrey Smith
• Kaitlin C Smith
• Ocie Lee Smith
• Shayna Elvina' Smith
• Thomas Joseph Smith, MD
• Daniel Drew Sobel
• Soil & Sprout Perinatal LLC
• Marina P Soler, RAS, BA
• Jack Jaeyoung Song

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Martinez, CA
• Providers in Martinez, CA by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.