1720173446 NPI number — MS. DEBORAH S. RENO-SMITH M.A.

Table of content: MS. DEBORAH S. RENO-SMITH M.A. (NPI 1720173446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720173446 NPI number — MS. DEBORAH S. RENO-SMITH M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RENO-SMITH
Provider First Name:
DEBORAH
Provider Middle Name:
S.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
DEBBIE
Provider Other Middle Name:
S.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFC 47268
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1720173446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23761 HAYES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURRIETA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92562-3455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-885-7177
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23761 HAYES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURRIETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92562-3455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-885-7177
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  47268 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 116 . This is a "LAC" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 2556 . This is a "LPC" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 47268 . This is a "MFC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com