Carlene Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13047 Issued in CA

Practice address

950 Boardwalk
Suitie 304
San Marcos, CA 92078-2600

Phone

(760) 809-3718

Fax

(760) 753-6446

NPI assigned

Jul 25, 2008

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1295990539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 BOARDWALK",
            "address_2": "SUITIE 304",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782600",
            "telephone_number": "760-809-3718",
            "fax_number": "760-753-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 BOARDWALK",
            "address_2": "SUITIE 304",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782600",
            "telephone_number": "760-809-3718",
            "fax_number": "760-753-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARLENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Marie Smallwood, OTR/L
• Brennan Smart
• Smile Community Clinic Inc
• Angelina Smith
• Bat Alexander Smith, M.D.
• Destiny Smith
• Gregory M Smith
• Kimberle Smith, APCC, PPS
• Sara Elizabeth Smith
• Stephanie Hunt Smith, DO

• Clinical Psychologist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.