Douglas Kent Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY8353 Issued in CA

Practice address

700 Coney CT
Santa Rosa, CA 95409-6124

Phone

(949) 481-7755

Fax

(949) 481-7744

NPI assigned

Dec 8, 2005

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1376528703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CONEY CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954096124",
            "telephone_number": "949-481-7755",
            "fax_number": "805-688-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CONEY CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954096124",
            "telephone_number": "949-481-7755",
            "fax_number": "949-481-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOUGLAS",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Josephine Smith, AU.D.
• Daniel P. Smith
• David Lyman Smith, M.D.
• David Michael Smith
• Decker Wood Smith
• Elizabeth Ashley Smith, OTR/L, C/NDT
• Elizabeth Jane Smith, MA
• Elizabeth Pointer Smith, CNM
• Jacqueline Smith, LCSW
• Jayson Smith

• Clinical Psychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.