Provider Demographics
NPI:1700077914
Name:SMITH, STEPHANI NOTIAS
Entity Type:Individual
Prefix:MS
First Name:STEPHANI
Middle Name:NOTIAS
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 1:1210 BELL ST
Mailing Address - Street 2:APT. 6B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3575
Mailing Address - Country:US
Mailing Address - Phone:916-529-0787
Mailing Address - Fax:
Practice Address - Street 1:2220 WATT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0512
Practice Address - Country:US
Practice Address - Phone:916-485-6500
Practice Address - Fax:916-485-6814
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health