PHYLICIA SMITH (NPI# 1114359973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114359973 |
| Entity Type | Individual |
| Full Name | PHYLICIA SMITH |
| Practice Address |
9500 Etiwanda Ave Rancho Cucamonga CA 91739-9662 |
| Mailing Address |
1330 E Cooley Dr Colton CA 92324-3905 |
| Practice Telephone | 9094635234 |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT 33961 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285264945 | Phylicia Smith | Behavior Technician | 10514 Racetrack Rd Ste C, Berlin, MD 21811-3241 | 2020-01-22 |
| Street Address |
9500 ETIWANDA AVE |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91739-9662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902847320 | Jeffrey A Haga | Family Medicine | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2006-06-09 |
| 1508303389 | Raizah Singh | Marriage & Family Therapist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2017-01-31 |
| 1275076119 | Garth Brown | Dentist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2016-11-27 |
| 1619331840 | Jack Cusator | Marriage & Family Therapist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2016-04-13 |
| 1548622525 | Heike Olafsen | Dentist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2016-03-28 |
| 1184095663 | Fillmore Lewis Smiley Iv | Behavioral Analyst | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2015-10-09 |
| 1700226289 | Nathan Kyle Turner | Psychologist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2013-06-28 |
| 1750627444 | Felix Sanchez | Psychologist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2012-12-27 |
| 1912264938 | Hafizullah Ajmal Azizi | Psychiatry & Neurology | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739 | 2012-04-15 |
| 1699031690 | Dane Rohan Beckford | Counselor | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2012-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699230300 | Gogo Medical Transport Inc. | Non-emergency Medical Transport (VAN) | 13269 Firestone Dr, Rancho Cucamonga, CA 91739 | 2019-02-06 |
| 1306348768 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 7210 Day Creek Blvd, Suite 110, Rancho Cucamonga, CA 91739 | 2018-03-01 |
| 1770082141 | Rajnis Jasani | Pharmacist | 7777-b Milliken Ave, Ste 100, Rancho Cucamonga, CA 91739 | 2018-02-12 |
| 1548787542 | Carla Hibet Castillo | Counselor | 7165 Etiwanda Ave, Rancho Cucamonga, CA 91739 | 2017-08-29 |
| 1598282428 | Yung Chun Chen | Dentist | 12453 Royal Oaks Dr., Montclair, CA 91739 | 2017-08-22 |
| 1508386806 | Emily Rose Marlen | Counselor | 845 E. Arrow Highway, Pomona, CA 91739 | 2017-06-27 |
| 1124384540 | Ameerah Rasheedah-bonner Mcmann | Marriage & Family Therapist | 8481 Etiwanda Avenue, Apartment G, Rancho Cucamonga, CA 91739 | 2012-04-10 |
| 1679866784 | Bodylogics Health Services Inc. | Rehabilitation Practitioner | 12730 Foothill Blvd., Unit 102, Rancho Cucamonga, CA 91739 | 2011-05-23 |
| 1801196027 | Lisa Louise Hazelwood | Psychologist | 9500 Etiwanda Ave., West Valley Detention Center, Attn: Medical Srvcs/liberty Roc, Rancho Cucamonga, CA 91739 | 2010-10-22 |
| 1700023520 | Gideon Puiyuen Kwok | Legal Medicine | 12225 Foothill Blvd #120, Rancho Cucamonga, CA 91739 | 2009-01-15 |
| Find all providers in zip 91739 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245894237 | Sheri Clara Irabor | Licensed Psychiatric Technician | 8250 Vineyard Ave Apt 24, Rancho Cucamonga, CA 91730-8703 | 2019-04-25 |
| 1710157557 | Delbert Perez | Licensed Psychiatric Technician | 10350 Baseline Rd Spc 232, Rancho Cucamonga, CA 91701-6084 | 2008-03-07 |
| 1396015210 | Monica Molina | Licensed Psychiatric Technician | 9047 Arrow Rte, Rancho Cucamonga, CA 91730 | 2012-01-09 |
| 1093092959 | Brian Keith Ragland | Licensed Psychiatric Technician | 9047 Arrow Rte, Suite170, Rancho Cucamonga, CA 91730-4449 | 2011-11-07 |
| 1154626232 | Misti D Palmer | Licensed Psychiatric Technician | 9047 Arrow Rte, Rancho Cucamonga, CA 91730-4449 | 2011-01-20 |
| 1780847541 | Isabelle Pina | Licensed Psychiatric Technician | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2008-07-02 |
| 1366613697 | John Kirby Miller II | Licensed Psychiatric Technician | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2008-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203592 | Leahann Vedella | Licensed Psychiatric Technician | 2398 Flatley Cir, Fairfield, CA 94533-8921 | 2020-10-23 |
| 1225635865 | Thalia I. Rochel | Licensed Psychiatric Technician | 450 E Temple St, Los Angeles, CA 90012-4022 | 2020-10-06 |
| 1427665090 | Egbert Tantiongco | Licensed Psychiatric Technician | 1460 E Willow St, Signal Hill, CA 90755-3549 | 2020-09-28 |
| 1114530250 | Heather Elizabeth Phillips | Licensed Psychiatric Technician | 4900 N Highway 99 Unit 68, Stockton, CA 95212-1007 | 2020-08-28 |
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1609491935 | Elisa Becerra | Licensed Psychiatric Technician | 745 Park St, Paso Robles, CA 93446-2834 | 2020-06-12 |
| 1518581099 | Theresa Lynn Stewart | Licensed Psychiatric Technician | 1110 Newport Way, Roseville, CA 95661-5315 | 2020-06-01 |
| 1093337511 | Christine Ann Scheuermann | Licensed Psychiatric Technician | 1447 Report Ave, Stockton, CA 95205-3030 | 2020-05-07 |
| 1477189512 | Sandra J Foshee | Licensed Psychiatric Technician | 48918 Mojave Dr, Morongo Valley, CA 92256-9243 | 2020-03-20 |
| 1376177725 | Chanel Christine Turpin | Licensed Psychiatric Technician | 450 Kings County Dr Ste 102, Hanford, CA 93230-5782 | 2020-02-25 |
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| City | RANCHO CUCAMONGA |
| Zip Code | 91739 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.