Smith, Jacquline S

Smith, Jacquline S is an sole proprietor health care provider with primary practice located at 2101 Courage Dr , Fairfield CA 94533-6717. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Smith, Jacquline S can be contacted via phone (707) 750-3000.

Contact Information

Primary practice address
2101 Courage Dr Fairfield CA 94533-6717
Phone: (707) 750-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1194042796
LBN Legal business name Smith, Jacquline S
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2010
Last updated Dec 25th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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