| Jackie Smith Jr, | |
|
9100 Brentwood Blvd, Brentwood, CA 94513-4000 | |
| (925) 809-7920 | |
| (925) 809-7928 |
| Full Name | Jackie Smith Jr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 9100 Brentwood Blvd, Brentwood, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154543866 | NPI | - | NPPES |
| 07557 | Other | CA | DMC ADOL BRENTWOOD |
| 0726 | Other | CA | DRUG M/CAL BILLING NUMBER |
| 56681 | Other | CA | STAFF ID NUMBER |
| 07553 | Other | CA | BRENTWOOD ADOL TX |
| 070726 | Other | CA | MASTER PROVIDER NUMBER |
| 070753 | Other | CA | MASTER PROVIDER FILE NUMB |
| 0753 | Other | CA | DRUG MEDI-CAL BILLING NO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie Smith Jr, 9100 Brentwood Blvd, Brentwood, CA 94513-4000 Ph: (925) 809-7920 | Jackie Smith Jr, 9100 Brentwood Blvd, Brentwood, CA 94513-4000 Ph: (925) 809-7920 |
Mrs. Nicole M Massari, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1210 Central Blvd Ste 116, Brentwood, CA 94513 Phone: 208-866-1822 | |
Hayley Rae Howard, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2838 Pristine Way, Brentwood, CA 94513 Phone: 408-375-1637 | |
Shawna Kurz, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 191 Sand Creek Rd Ste 202g, Brentwood, CA 94513 Phone: 925-237-6880 Fax: 925-237-6880 | |
Mr. Jose Guizar, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1191 Central Blvd Ste A, Brentwood, CA 94513 Phone: 925-634-4445 Fax: 925-634-6235 | |
Mr. George Nikolas Pauls, MSW, CHES Counselor Medicare: Not Enrolled in Medicare Practice Location: 1323 Muscat Ct, Brentwood, CA 94513 Phone: 925-513-2495 | |
Harriett Matthews, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9100 Brentwood Blvd, Brentwood, CA 94513 Phone: 925-809-7920 Fax: 925-809-7928 |