Individual
TONYA LANETT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1552 COFFEE RD STE 200, MODESTO, CA 95355-3122
(209) 248-7168
(209) 846-9641
Mailing address
PO BOX 1750, MANTECA, CA 95336-1153
(209) 665-8566
(209) 846-9641
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19549
CA
Other
Enumeration date
01/31/2008
Last updated
07/21/2022
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