Kelsey Andrea Kemp Smith

Primary specialty

Social WorkerTaxonomy code 104100000X

License

127288 Issued in CA

Practice address

58967 Business Center Dr Ste C&D
Yucca Valley, CA 92284-7308

Phone

(760) 369-3130

NPI assigned

Mar 27, 2023

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1417651399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071221",
            "telephone_number": "760-552-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58967 BUSINESS CENTER DR STE C&D",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847308",
            "telephone_number": "760-369-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELSEY",
        "middle_name": "ANDREA KEMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "127288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Smallwood
• Dana Deprophetis Smith, L.AC.
• Janet N Smith
• Jaziah M Smith
• Jeffrey Stuart Smith, L.AC.
• Lavina Marie Smith
• Marlena E Smith
• Phonicia Smith
• Roger Allen Smith Jr.
• Sydney Smith

• Social Worker in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.