Healthcare Provider Details

I. General information

NPI: 1386807063
Provider Name (Legal Business Name): DEBORAH SCHOENLEIN SMITH RN MS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 VETERANS BLVD SUITE 300
REDWOOD CITY CA
94063-1715
US

IV. Provider business mailing address

2843 SYCAMORE WAY
SANTA CLARA CA
95051-5641
US

V. Phone/Fax

Practice location:
  • Phone: 650-299-4959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number2560
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number377849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: