Individual
JACQUNISHA WA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4081 DALE RD APT D, MODESTO, CA 95356-9609
(650) 501-2160
Mailing address
4081 DALE RD APT D, MODESTO, CA 95356-9609
(650) 501-2160
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
CA
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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