NPIMap

Individual provider Active NPI

Julian Shane Smith, M.D.

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1316002892
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A95462 Issued in CA
Practice address
1410 F St Ste 110
Fresno, CA 93706-1608
Phone
(559) 256-7600
Fax
(559) 256-1081
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A95462 CA Primary

Addresses

Primary practice location

1410 F St Ste 110
Fresno, CA 93706-1608

Mailing address

PO Box 942030
Plano, TX 75094-2030
Phone (858) 405-6162

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address juliansmith@kingsview.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090302000153 CA Practitioner - Psychiatry 8426155490 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, San Diego School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of TrinityGroup PAC ID 6507850385, 4 clinicians
County of del NorteGroup PAC ID 8527073949, 9 clinicians

Practice addresses (Care Compare)

1450 Main St
Weaverville, CA 96093-1640
Phone (530) 623-1922

455 K St
Crescent City, CA 95531-4107
Phone (707) 464-0860

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A95462CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Glenn CurrentSince Mar 8, 2017 Accepting new patients
Saint Agnes Medical Center CurrentSince Nov 6, 2015 Accepting new patients
County of Tuolumne CurrentSince Jun 10, 2021 Accepting new patients
Trinity Home Health Services CurrentSince Nov 6, 2015 Accepting new patients
County of Glenn CurrentSince Mar 8, 2017 Accepting new patients
County of del Norte CurrentSince Jul 1, 2021 Accepting new patients
Trinity County Past Accepting new patients

Locations

455 K St
Crescent City, CA 95531
Phone (707) 464-0860

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

105 Hospital Rd
Sonora, CA 95370
Phone (209) 533-6245

242 N Villa Ave
Willows, CA 95988
Phone (530) 934-6347

Organizations & group practices 8

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

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1316002892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 942030",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750942030",
            "telephone_number": "858-405-6162",
            "fax_number": "559-256-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 F ST STE 110",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937061608",
            "telephone_number": "559-256-7600",
            "fax_number": "559-256-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JULIAN",
        "middle_name": "SHANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A95462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "juliansmith@kingsview.org",
            "affiliation": "N",
            "address_1": "1410 F St Ste 110",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937061608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.