Christina Smith

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Camino, CA

NPI 1790502003 · NPPES record last updated Sep 26, 2024

Key facts

NPI
1790502003
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
5494 Pony Express TRL
Camino, CA 95709-9403
Phone
(530) 644-3758
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Progress House, Inc. Past
since Sep 29, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

5494 Pony Express TRL
Camino, CA 95709-9403

Mailing address

2844 Coloma St
Placerville, CA 95667-4406

Other providers in Camino, CA

All providers in Camino, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.