Provider Demographics
NPI:1851180061
Name:SMITH, CHRISTOPHER KEITH
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KEITH
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:KEITH
Other - Last Name:SONNIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:34448 YUCAIPA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-2412
Mailing Address - Country:US
Mailing Address - Phone:909-353-7547
Mailing Address - Fax:
Practice Address - Street 1:34448 YUCAIPA BLVD STE A
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-2412
Practice Address - Country:US
Practice Address - Phone:909-353-7547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst