Provider Demographics
NPI:1831175926
Name:SMITH, YVONNE M (PA)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4150 V ST
Mailing Address - Street 2:PSSB-SUITE 1200, MED: ANESTHESIA
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-7985
Mailing Address - Fax:916-734-2975
Practice Address - Street 1:4150 V ST
Practice Address - Street 2:PSSB-SUITE 1200, MED: ANESTHESIA
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-7985
Practice Address - Fax:916-734-2975
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2022-01-03
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Provider Licenses
StateLicense IDTaxonomies
CA0014453363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA009410OtherPHYSICIAN INDEX #
CAS57043Medicare UPIN