Provider Demographics
NPI:1619653177
Name:SMITH, NAYELI (MSW, ASW)
Entity Type:Individual
Prefix:
First Name:NAYELI
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:NAYELI
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1075 CALLE DEL SOL
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-7710
Mailing Address - Country:US
Mailing Address - Phone:760-886-2440
Mailing Address - Fax:
Practice Address - Street 1:3843 CHEROKEE AVE APT 5
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-7121
Practice Address - Country:US
Practice Address - Phone:760-886-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW99014104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker