Carla Smith, PSY.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY25810 Issued in CA

Practice address

251 Georgia St
Vallejo, CA 94590-5905

Phone

(707) 534-6065

Fax

(707) 558-8196

NPI assigned

Apr 20, 2009

Last updated

Aug 22, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1982847059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 GEORGIA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905905",
            "telephone_number": "707-534-6065",
            "fax_number": "707-558-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 GEORGIA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905905",
            "telephone_number": "707-534-6065",
            "fax_number": "707-558-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY25810",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinita Denise Smith-Sepolen
• Aaron J Smith, PT
• Allison Louise Smith
• Amy Suzanne Smith, P.T., M.S.
• Antoinette Rochelle Smith
• Christine Smith, NURSE PRACTITIONER
• Judith Gail Smith, NP
• Madeline Irene Smith, MD
• Mark Allan Smith, MD
• Richard Lyn Smith

• Forensic Psychologist in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.