Wilbert Smith, CLINICAL PSYCH

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PSB94028313 Issued in CA

Practice address

877 N Douglas St., Pacific Psychological Ass.
El Segundo, CA 90242

Phone

(310) 299-5910

Fax

(310) 504-2249

NPI assigned

Aug 8, 2025

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

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": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1619852522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1776",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900010776",
            "telephone_number": "310-299-5910",
            "fax_number": "310-504-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 N DOUGLAS ST., PACIFIC PSYCHOLOGICAL ASS.",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "310-299-5910",
            "fax_number": "310-504-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILBERT",
        "name_prefix": "Dr.",
        "credential": "CLINICAL PSYCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-08",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "PSB94028313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Smith
• Mya Smith
• Nakiyah Tyshae Smith
• Sylvia Smith
• Tessie Smith
• William Smith
• Zachariah S Smith, DO
• Ashley Snell
• Danielle Snyder
• Janice Dee Snyder, PH.D.

• Student in an Organized Health Care Education/Training Program in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.