Provider Demographics
NPI:1689478687
Name:SMITH, NELL YSABEL (MA, BEH SCIENCE)
Entity type:Individual
Prefix:MRS
First Name:NELL
Middle Name:YSABEL
Last Name:SMITH
Suffix:
Gender:
Credentials:MA, BEH SCIENCE
Other - Prefix:MS
Other - First Name:NELL
Other - Middle Name:YSABEL
Other - Last Name:ALCANTARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3001 E TAHQUITZ CANYON WAY # 104103
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6982
Mailing Address - Country:US
Mailing Address - Phone:760-202-4308
Mailing Address - Fax:
Practice Address - Street 1:3001 E TAHQUITZ CANYON WAY STE 103
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6900
Practice Address - Country:US
Practice Address - Phone:760-202-4308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator