Provider Demographics
NPI:1215751334
Name:SMITH, GIGI MARIA (MBA, PMP)
Entity type:Individual
Prefix:DR
First Name:GIGI
Middle Name:MARIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MBA, PMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PLEASANT GROVE BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6268
Mailing Address - Country:US
Mailing Address - Phone:916-217-7443
Mailing Address - Fax:916-773-5950
Practice Address - Street 1:697 TAMARINDO WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5976
Practice Address - Country:US
Practice Address - Phone:916-410-2007
Practice Address - Fax:916-773-5950
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE175T00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No175T00000XOther Service ProvidersPeer Specialist