MEDICARE: KAMEKA SMITH RAS INTERN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1952600298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMEKA SMITH RAS INTERN

Provider Business Mailing Address
First Line	:	1841 BERKELEY WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-1576
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1841 BERKELEY WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-1576
Country	:	US
Telephone Number	:	510-559-3558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	03/25/2011

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Directions to “ KAMEKA SMITH RAS INTERN” Practice Location

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