Provider Demographics
NPI:1053017384
Name:RAIFORD-SMITH, ALVENA IOLA
Entity type:Individual
Prefix:
First Name:ALVENA
Middle Name:IOLA
Last Name:RAIFORD-SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 WALNUT MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3134
Mailing Address - Country:US
Mailing Address - Phone:510-731-4014
Mailing Address - Fax:
Practice Address - Street 1:1408 WALNUT MEADOWS DR
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3134
Practice Address - Country:US
Practice Address - Phone:510-731-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician