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Individual

MR. EDWARD LEON SMITH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1803 W MARCH LN, STOCKTON, CA 95207-6458
(209) 636-5353
Mailing address
1827 BELLA LAGO DR, STOCKTON, CA 95206-1124
(510) 331-5664

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
CA

Other

Enumeration date
09/25/2025
Last updated
09/29/2025
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