Provider Demographics
NPI:1205252533
Name:SMITH, JAMEESE B
Entity type:Individual
Prefix:MISS
First Name:JAMEESE
Middle Name:B
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 1:742 N LA BREA AVE.
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302
Mailing Address - Country:US
Mailing Address - Phone:310-672-4078
Mailing Address - Fax:323-544-6322
Practice Address - Street 1:159 W 110TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2013
Practice Address - Country:US
Practice Address - Phone:310-625-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator