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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JUSTIN SMITH
NPI 1649199456
Student in an Organized Health Care Education/Training Program in Santa Rosa, CA

Active since July 14, 2026
2235 MERCURY WAY STE 107, SANTA ROSA, CA 95407(707) 571-5581 Get Directions Write a Review

NPPES record added: July 14, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Justin Smith NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN SMITH (NPI 1649199456) is an individual student in an organized health care education/training program in Santa Rosa, California and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1649199456
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJUSTIN SMITH
Location Address2235 MERCURY WAY STE 107Santa Rosa, CA 95407-5472
Mailing Address2235 Mercury Way Ste 107Santa Rosa, CA 95407-5472 · (707) 571-5581
Phone(707) 571-5581
Sole ProprietorYes
Enumeration DateJuly 14, 2026
NPPES CertifiedJuly 14, 2026
✔ NPI 1649199456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2235 MERCURY WAY STE 107, Santa Rosa, CA 95407
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGEL STEVEN ESCOBAR
Day Training/Habilitation Specialist
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 571-5581
MR. VERNON D POPE-BANKS
Rehabilitation Practitioner
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 571-5581
MRS. BRANDI CASWELL
Specialist
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 571-5581
KENDRA N NEESE
Rehabilitation Practitioner
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 231-0741
KATIE SWAN
Rehabilitation Practitioner
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 583-5284
MISS ANNALISE MADSEN
Rehabilitation Practitioner
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 571-5581
JASON SELVAGE M.A.
Rehabilitation Practitioner
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 695-2805
VERONICA GRAY
Specialist
2235 MERCURY WAY STE 107
SANTA ROSA, CA 95407
Sonoma County (707) 909-0897

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Smith's NPI number?

The NPI number for Justin Smith is 1649199456. It was assigned to this individual provider in the NPPES registry on July 14, 2026.

Where is Justin Smith located?

Justin Smith practices at 2235 Mercury Way Ste 107, Santa Rosa, CA 95407. The listed phone number is (707) 571-5581.

What is Justin Smith's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Justin Smith was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.