Camille Dian Smith

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

16902 1St St
Victorville, CA 92395-3111

Phone

(760) 530-7903

NPI assigned

Sep 29, 2026

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1205740008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16902 1ST ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953111",
            "telephone_number": "760-530-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16902 1ST ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953111",
            "telephone_number": "760-530-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAMILLE",
        "middle_name": "DIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "IEHPProviderPortal",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "16902 1st St",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tracy Small III, AMFT APCC
• Loyia Smiley
• Jamie Tyushi Smith-Baber, REGISTERED NURSE
• Ashley Smith
• Benjamin Andrew Smith, BCBA
• Charles Stuart Smith, RADT R1543910124
• Edwina Smith, RN
• Jessica C Smith, FNP
• Kaden Thomas Smith
• Kasey Smith

• Community Health Worker in Victorville, CA
• Providers in Victorville, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.