Cassandra Rene'E Smullen

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

37323 Issued in CA

Practice address

1803 W March LN
Stockton, CA 95207-6414

Phone

(209) 636-5353

NPI assigned

Aug 21, 2019

Last updated

Aug 21, 2019By the provider in NPPES

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": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1972150274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076414",
            "telephone_number": "209-636-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076414",
            "telephone_number": "209-636-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMULLEN",
        "first_name": "CASSANDRA",
        "middle_name": "RENE'E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "37323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Smith, NP
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• Yvonne Smith
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• Shanai Marie Sneed
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• SNH Cal Tenant LLC (Somerford Place - Stockton)
• Allison Snider, DPT

• Licensed Psychiatric Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.