Provider Demographics
NPI:1245429067
Name:SMITH, ALYSON LEIGH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 27TH ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2116
Mailing Address - Country:US
Mailing Address - Phone:310-678-4272
Mailing Address - Fax:
Practice Address - Street 1:323 27TH ST
Practice Address - Street 2:UNIT B
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2116
Practice Address - Country:US
Practice Address - Phone:310-678-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA078583367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered