Provider Demographics
NPI:1427937135
Name:SMITH, BRIANNE NICHOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:NICHOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3018 BUTTE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3531
Mailing Address - Country:US
Mailing Address - Phone:619-922-0862
Mailing Address - Fax:
Practice Address - Street 1:3018 BUTTE AVE
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-3531
Practice Address - Country:US
Practice Address - Phone:619-922-0862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17403235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist