Individual
KENYA DENETTE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 VAN NUYS BLVD STE 305, SHERMAN OAKS, CA 91403-1717
(818) 480-6456
(818) 205-1924
Mailing address
5000 VAN NUYS BLVD STE 305, SHERMAN OAKS, CA 91403-1717
(818) 480-6456
(818) 205-1924
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
578715
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95000220
CA
Other
Enumeration date
01/15/2014
Last updated
04/08/2014
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