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Individual

MR. SHAWN PATRICK SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.P.T.

Contact information

Practice address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
(909) 865-9281
Mailing address
746 INVERGARRY ST, GLENDORA, CA 91741-3227
(626) 857-0414

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 29677
CA

Other

Enumeration date
05/07/2007
Last updated
07/08/2007
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