Individual
TYRONE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50249 CESAR CHAVEZ ST STE K, COACHELLA, CA 92236-1530
(760) 393-0555
(760) 393-0522
Mailing address
50249 CESAR CHAVEZ ST STE K, COACHELLA, CA 92236-1530
(760) 393-0555
(760) 393-0522
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95015797
CA
Other
Enumeration date
03/14/2019
Last updated
12/31/2021
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