Provider Demographics
NPI:1841459450
Name:SMITH, VALERIE (RD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 27TH ST
Mailing Address - Street 2:SUITE 401B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2055
Mailing Address - Country:US
Mailing Address - Phone:661-869-6176
Mailing Address - Fax:661-869-6938
Practice Address - Street 1:1524 27TH ST
Practice Address - Street 2:SUITE 401B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2055
Practice Address - Country:US
Practice Address - Phone:661-869-6176
Practice Address - Fax:661-869-6938
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA943270133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ55920Medicare UPIN