Look up the most recent NPI and PECOS records

Jennifer Nicole Smith

Marriage & Family Therapist

Behavioral Health & Social Service Providers

3850 Crenshaw Blvd, Los Angeles, CA 90008-1821

PECOS Enrollment

Based on the most recent information from CMS, provider Jennifer Nicole Smith does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1780119065
Provider Type
Individual
Full Name
Smith, Jennifer Nicole
Gender
Female

Sole Proprietor
Yes
Enumeration Date
4/25/2017
Last Updated
12/13/2022

Contact Information

Practice Location

3850 Crenshaw Blvd, Los Angeles, CA 90008-1821

(310) 631-8004

(310) 631-5875

Mailing Location

3850 Crenshaw Blvd, Los Angeles, CA 90008-1821

(310) 631-8004

(310) 631-5875

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License AMFT122639 California
Code 101Y00000X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License AMFT122639 California
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 171M00000X	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer

Jennifer Nicole Smith

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Vargas, Maria E.

Emery, Mikkela Jazzmine

Woods, Summer Breanna

Franklin, Jamie Lynn

Labuckas, Ivana Luisa

Arredondo, Jazmin Antonieta

Florian, Jacqueline

Reams, Bennie Phillips