Individual
BYRON SMITH SR. SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1770 E 118TH ST, LOS ANGELES, CA 90059-2518
(323) 793-2375
Mailing address
1770 E 118TH ST, LOS ANGELES, CA 90059-2518
(323) 793-2375
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PCCI2672
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326407958
—
CA
05
—
7721
—
CA
Enumeration date
02/10/2016
Last updated
04/16/2019
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