Provider Demographics
NPI:1104593623
Name:THOMPSON SMITH, SPRINGLEN (CNA)
Entity type:Individual
Prefix:
First Name:SPRINGLEN
Middle Name:
Last Name:THOMPSON SMITH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 HART CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6714
Mailing Address - Country:US
Mailing Address - Phone:323-601-3013
Mailing Address - Fax:
Practice Address - Street 1:2012 HART CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-6714
Practice Address - Country:US
Practice Address - Phone:323-601-3013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00604226376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide