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Individual

DR. STEPHANIE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
030877
OR
231H00000X
Audiologist
Primary
AU2599
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AU2599
CALIFORNIA AUDIOLOGY LICENSE
Enumeration date
07/23/2008
Last updated
03/08/2025
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