Sheldon Smith

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

686 E Mill St
San Bernardino, CA 92415-1729

Phone

(909) 798-8455

NPI assigned

Jun 24, 2022

Last updated

Oct 14, 2022By the provider in NPPES

Sex

Male

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

Practice roles

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

• County of San Bernardino

  dba DAAS Age Wise

  • Adult Mental Health Clinic/Center
  • San Bernardino, CA
  • NPI 1598328072
  NPD (past)

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1235861717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11261 SAN MATEO DR APT 2",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 E MILL ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151729",
            "telephone_number": "909-798-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Lamar Smith
• Safiya Renee Smith
• Sakeena Smith
• Sammantha A Smith
• Shedella Aarin Smith
• Takiera Smith
• Taylor Smith
• Tiffany Nicole Smith
• Tina Marie Smith
• Tricina L Smith, RN, PMHNP

• 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 Oct 14, 2022; 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.