Provider Demographics
NPI:1750736005
Name:SMOTHERS, DAMAILI KAMILI (RADT-1)
Entity type:Individual
Prefix:MRS
First Name:DAMAILI
Middle Name:KAMILI
Last Name:SMOTHERS
Suffix:
Gender:F
Credentials:RADT-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9355 E STOCKTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-9476
Mailing Address - Country:US
Mailing Address - Phone:916-714-5400
Mailing Address - Fax:
Practice Address - Street 1:7240 E SOUTHGATE DR STE G
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2627
Practice Address - Country:US
Practice Address - Phone:916-391-4293
Practice Address - Fax:916-391-4247
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-24
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB4042003372600000X, 101YA0400X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes372600000XNursing Service Related ProvidersAdult Companion
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)