Provider Demographics
NPI:1083408447
Name:SMITH, VERNIA R JR
Entity type:Individual
Prefix:MR
First Name:VERNIA
Middle Name:R
Last Name:SMITH
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5363 H ST STE B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3555
Mailing Address - Country:US
Mailing Address - Phone:916-730-1679
Mailing Address - Fax:
Practice Address - Street 1:5363 H ST STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3555
Practice Address - Country:US
Practice Address - Phone:916-730-1679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist