Provider Demographics
NPI:1235701756
Name:SMITH, ARTEJA LYNN RISING
Entity Type:Individual
Prefix:
First Name:ARTEJA
Middle Name:LYNN RISING
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 H ST APT 1
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1120
Mailing Address - Country:US
Mailing Address - Phone:707-927-8551
Mailing Address - Fax:
Practice Address - Street 1:2751 NAPPY VALLEY CORPORATE DRIVE, BLDG. B
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-210-2437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator