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Collis Smith
Licensed Psychiatric Technician in San Bernardino, California
NPI 1184959173

Collis Smith is a Licensed Psychiatric Technician based in Fontana, CA. Collis Smith practices in San Bernardino, CA. The NPI Number for Collis Smith is 1184959173 and holds a License No. 34214 (California).

The current practice location address for Collis Smith is 2080 S E St, San Bernardino, CA and can be reached out via phone at 909-825-8989. You can also correspond with Collis Smith through the mailing address at 11650 CHERRY AVE, FONTANA, CA - 92337-2786 (mailing address contact number: 909-904-9465).

Location: 2080 S E St, San Bernardino, CA, 92337-2786
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184959173
Provider Name
Collis Smith
Credential
Provider Entity Type
Individual
Gender
Male
Address
2080 S E St, San Bernardino, CA, 92337-2786
Phone Number
909-825-8989
Fax Number
Provider Enumeration Date
10/08/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1124100383 05 CA
institution
Provider Business Practice Location Address Details
Address
2080 S E St
City
San Bernardino
State
California
Zip
92408-2706
Phone Number
909-825-8989
Fax Number
person
Provider Business Mailing Address Details
Address
2080 S E St
City
San Bernardino
State
California
Zip
92408-2706
Phone Number
909-825-8989
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Psychiatric Technician
Speciality
-
Taxonomy
167G00000X
License No.
34214 (California)
Definition
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
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