Kevin M. Smith, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

95128556 Issued in CA

Practice address

210 W. San Bernardino Rd.
Attn. Mental Health Unit
Covina, CA 91723

Phone

(626) 331-7331

Fax

(626) 859-5854

NPI assigned

Sep 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1631404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1407525462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W. SAN BERNARDINO RD.",
            "address_2": "ATTN. MENTAL HEALTH UNIT",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91723",
            "telephone_number": "626-331-7331",
            "fax_number": "626-859-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W. SAN BERNARDINO RD.",
            "address_2": "ATTN. MENTAL HEALTH UNIT",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91723",
            "telephone_number": "626-331-7331",
            "fax_number": "626-859-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-12",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95128556",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "95128556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.emanatehealth.org",
            "affiliation": "N",
            "address_1": "250 S Grand Ave",
            "city": "Glendora",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917414218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dominique Smith
• Elijah Isaiah Smith
• John Keith Smith, PH.D., LCSW
• Joshua Lou Smith
• Kai Filip Smith
• Kyle Smith
• Ma'Sha Smith, PSYD, PPS
• Mikki Lee Smith
• Ralph Jerry Smith, D.D.S.
• Sarah Beth Smith

• Adult Psychiatric/Mental Health Registered Nurse in Covina, CA
• Providers in Covina, CA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.