Provider Demographics
NPI:1073316824
Name:SMITH, JANE F (PPS SCHOOL COUNSELOR)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:F
Last Name:SMITH
Suffix:
Gender:
Credentials:PPS SCHOOL COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3129
Mailing Address - Country:US
Mailing Address - Phone:619-445-8676
Mailing Address - Fax:619-445-1420
Practice Address - Street 1:2320 TAVERN RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-3134
Practice Address - Country:US
Practice Address - Phone:619-445-8676
Practice Address - Fax:619-445-1420
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool