Healthcare Provider Details

I. General information

NPI: 1053233965
Provider Name (Legal Business Name): SHAY SMITH MA, MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 VETERANS BLVD STE 204
REDWOOD CITY CA
94063-1419
US

IV. Provider business mailing address

617 VETERANS BLVD STE 204
REDWOOD CITY CA
94063-1419
US

V. Phone/Fax

Practice location:
  • Phone: 650-619-0119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number94029704
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: