Ronald Russell Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13539 Issued in CA

Practice address

17216 Slover Ave Ste L
Fontana, CA 92337-7580

Phone

(909) 854-3420

NPI assigned

Feb 5, 2007

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902945496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 NAPOLI WAY",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835272",
            "telephone_number": "951-487-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17216 SLOVER AVE STE L",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377580",
            "telephone_number": "909-854-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RONALD",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth B. Smith, MD
• Garran Alexander Smith
• Jacqueline L Smith
• Jennifer A Smith, NP
• Jonathan Isaiah Smith, D.O.
• Terence Smith
• Tiffany Smith, MASSAGE THERAPIST
• Vianey Areli Smith, AMFT
• Howard L Snyder, OD
• Stephanie Soe

• Clinical Psychologist in Fontana, CA
• Providers in Fontana, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.