Provider Demographics
NPI:1063000248
Name:AARON D. SMITH, PSY.D. A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:AARON D. SMITH, PSY.D. A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:951-317-4499
Mailing Address - Street 1:4160 TEMESCAL CANYON RD STE 309
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4629
Mailing Address - Country:US
Mailing Address - Phone:951-317-4499
Mailing Address - Fax:
Practice Address - Street 1:4160 TEMESCAL CANYON RD STE 309
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-4629
Practice Address - Country:US
Practice Address - Phone:951-317-4499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)