Sandra Jazmin Smith, RBT

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107

Phone

(209) 452-8996

NPI assigned

Mar 18, 2018

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

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

{
    "created_epoch": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1184127904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16713 VICTORIAN TRL",
            "city": "LATHROP",
            "state": "CA",
            "postal_code": "953308835",
            "telephone_number": "209-808-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 GRAND CANAL BLVD STE 2",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078107",
            "telephone_number": "209-452-8996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Tupelo Dr",
            "address_purpose": "LOCATION",
            "city": "Citrus Heights",
            "state": "CA",
            "postal_code": "956211741",
            "country_code": "US",
            "telephone_number": "916-729-3098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Fairway Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411817",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SANDRA",
        "middle_name": "JAZMIN",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-18",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Alice Smith, PH.D.
• Paul Smith
• Paula Ann Smith, MFTI
• Samantha Smith
• Sammantha Smith
• Stephanie Lynn Smith
• Stephen Eugene Smith
• Vanessa Smith, NP
• Whitney Marcelle Smith
• William Smith

• Other Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Other Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.