Healthcare Provider Details

I. General information

NPI: 1871311951
Provider Name (Legal Business Name): ALIZE MARIE HURD-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2024
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 ALVA ST
CARPINTERIA CA
93013-1501
US

IV. Provider business mailing address

1483 ALVA ST
CARPINTERIA CA
93013-1501
US

V. Phone/Fax

Practice location:
  • Phone: 805-566-0299
  • Fax:
Mailing address:
  • Phone: 805-566-0299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: