Provider Demographics
NPI:1326635137
Name:SMART THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:SMART THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:AFABLE
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-933-0070
Mailing Address - Street 1:3 MONTECITO DR
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1017
Mailing Address - Country:US
Mailing Address - Phone:949-933-0070
Mailing Address - Fax:
Practice Address - Street 1:3 MONTECITO DR
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1017
Practice Address - Country:US
Practice Address - Phone:949-933-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)