Jacqueline L Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

91291 Issued in CA

Practice address

7426 Cherry Ave Ste 210-627
Fontana, CA 92336

Phone

(909) 684-3642

NPI assigned

Aug 23, 2011

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

Other identifiers 1

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": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1912287996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7426 CHERRY AVE STE 210-627",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364221",
            "telephone_number": "909-684-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7426 CHERRY AVE STE 210-627",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92336",
            "telephone_number": "909-684-3642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 N Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917622729",
            "country_code": "US",
            "telephone_number": "909-983-2020 x2224",
            "fax_number": "909-983-6847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 N Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "91762",
            "country_code": "US",
            "telephone_number": "909-983-2020 x2224",
            "fax_number": "909-983-6847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 N Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "91762",
            "country_code": "US",
            "telephone_number": "909-983-2020 x2224",
            "fax_number": "909-983-6847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7426 Cherry Ave Ste 210-627",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923364221",
            "country_code": "US",
            "telephone_number": "909-684-3642 x90956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7426 Cherry Ave Ste 210-627",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "92336",
            "country_code": "US",
            "telephone_number": "909-684-3642 x90956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-1946482",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby Lawrence Smith, CHIROPRACTOR
• Chandra Smith, M.S.
• Christine L Smith, LCSW
• Elizabeth B. Smith, MD
• Garran Alexander Smith
• Jennifer A Smith, NP
• Jonathan Isaiah Smith, D.O.
• Ronald Russell Smith, PH.D.
• Terence Smith
• Tiffany Smith, MASSAGE THERAPIST

• Clinical Social Worker in Fontana, CA
• Providers in Fontana, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.