Individual
ASIA MONIQUE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6302 13TH AVE, LUCERNE, CA 95458
(707) 274-9101
(707) 263-5220
Mailing address
15145 LAKESHORE DR, CLEARLAKE, CA 95422-8106
(707) 994-7090
(707) 263-5220
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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