Provider Demographics
NPI:1043269426
Name:SMITH, YINETH ROCIO (MD)
Entity type:Individual
Prefix:
First Name:YINETH
Middle Name:ROCIO
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YINETH
Other - Middle Name:ROCIO
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1133 E STANLEY BLVD
Mailing Address - Street 2:#103
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4200
Mailing Address - Country:US
Mailing Address - Phone:925-455-5050
Mailing Address - Fax:925-455-5084
Practice Address - Street 1:1133 E STANLEY BLVD
Practice Address - Street 2:#103
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4200
Practice Address - Country:US
Practice Address - Phone:925-455-5050
Practice Address - Fax:925-455-5084
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76411208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics