Provider Demographics
NPI:1316828569
Name:SMITH, MAYA L (MPH, CD, CLC, YT)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:MPH, CD, CLC, YT
Other - Prefix:
Other - First Name:M
Other - Middle Name:L
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:633 1/2 ROMULO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:633 1/2 ROMULO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-1608
Practice Address - Country:US
Practice Address - Phone:520-982-2197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula