Individual
M. ELENA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1068 ROY FRERICHS LN, TRACY, CA 95377-6605
(209) 914-0494
Mailing address
1068 ROY FRERICHS LN, TRACY, CA 95377-6605
(209) 914-0494
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41522
CA
Other
Enumeration date
03/18/2020
Last updated
01/10/2024
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