Individual
DANIEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1604 N PENNSYLVANIA AVE, SAN BERNARDINO, CA 92411-1171
(909) 713-2016
Mailing address
1604 N PENNSYLVANIA AVE, SAN BERNARDINO, CA 92411-1171
(909) 713-2016
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000000
NA
—
Enumeration date
04/25/2019
Last updated
07/02/2025
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