Individual
SANDRA JAZMIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1811 GRAND CANAL BLVD STE 2, STOCKTON, CA 95207-8107
(209) 452-8996
Mailing address
16713 VICTORIAN TRL, LATHROP, CA 95330-8835
(209) 808-2745
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/18/2018
Last updated
11/29/2021
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