Healthcare Provider Details

I. General information

NPI: 1114738135
Provider Name (Legal Business Name): KIAUNA DAY-SMITH MS, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45135 S GRIMMER BLVD
FREMONT CA
94539-6631
US

IV. Provider business mailing address

3777 MOWRY AVE APT 18
FREMONT CA
94538-1442
US

V. Phone/Fax

Practice location:
  • Phone: 510-651-6958
  • Fax:
Mailing address:
  • Phone: 831-713-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number240182317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: