Provider Demographics
NPI:1801270244
Name:KAPOOR, SMITA
Entity type:Individual
Prefix:MRS
First Name:SMITA
Middle Name:
Last Name:KAPOOR
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 1:12495 MELON DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8983
Mailing Address - Country:US
Mailing Address - Phone:626-354-1987
Mailing Address - Fax:
Practice Address - Street 1:1260 E ARROW HWY BLDG E
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4984
Practice Address - Country:US
Practice Address - Phone:626-354-1987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist