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Individual

JESSE EDWARD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
373H0000X

Contact information

Practice address
1141 CHELSEA ST, RIDGECREST, CA 93555-3208
(760) 463-2880
(760) 446-0298
Mailing address
1141 CHELSEA ST, RIDGECREST, CA 93555-3208
(760) 463-2880
(760) 446-0298

Taxonomy

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

Other

Enumeration date
07/19/2023
Last updated
03/25/2025
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