Kashanta Shanea Dartez-Smith | Stockton, CA • PECOS Search

Kashanta Shanea Dartez-Smith

Counselor

Behavioral Health & Social Service Providers

1414 N California St, Stockton, CA 95202-1515

(209) 468-2385 (209) 401-4981

PECOS Enrollment

Based on the most recent information from CMS, provider Kashanta Shanea Dartez-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 yesterday at 12:57 PM.

Profile Details

Provider ID
1508193178
Provider Type
Individual
Full Name
Dartez-Smith, Kashanta Shanea
Gender
Female

Sole Proprietor
Yes
Enumeration Date
11/3/2009
Last Updated
11/3/2009

Contact Information

Practice Location

1414 N California St, Stockton, CA 95202-1515

Unlisted Fax

Mailing Location

1653 E 6th St, Stockton, CA 95206-2305

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer