Provider Demographics
NPI:1962390005
Name:SMITH, BLYTHE ASHLEY (LM, CPM)
Entity type:Individual
Prefix:
First Name:BLYTHE
Middle Name:ASHLEY
Last Name:SMITH
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3376 SAN GABRIEL AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5200
Mailing Address - Country:US
Mailing Address - Phone:831-245-6844
Mailing Address - Fax:
Practice Address - Street 1:6103 N 1ST ST STE 104
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5461
Practice Address - Country:US
Practice Address - Phone:831-245-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM768176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife