Provider Demographics
NPI:1528329885
Name:DANIEL S SMITH PHD INC APC
Entity type:Organization
Organization Name:DANIEL S SMITH PHD INC APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:909-399-0556
Mailing Address - Street 1:250 W 1ST ST
Mailing Address - Street 2:352
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4736
Mailing Address - Country:US
Mailing Address - Phone:909-399-0556
Mailing Address - Fax:909-624-2137
Practice Address - Street 1:250 W 1ST ST
Practice Address - Street 2:352
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4736
Practice Address - Country:US
Practice Address - Phone:909-399-0556
Practice Address - Fax:909-624-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty