Provider Demographics
NPI:1801692058
Name:SMIDDY, DELANEY LYNN
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:LYNN
Last Name:SMIDDY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 S FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6045
Mailing Address - Country:US
Mailing Address - Phone:833-747-4222
Mailing Address - Fax:831-400-5554
Practice Address - Street 1:1821 S FREEMAN ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6045
Practice Address - Country:US
Practice Address - Phone:833-747-4222
Practice Address - Fax:831-400-5554
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst