Healthcare Provider Details

I. General information

NPI: 1154411619
Provider Name (Legal Business Name): LINDA F SMITH CERT RESP. THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

1650 WALLACE AVE
SAN FRANCISCO CA
94124-3238
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-3047
  • Fax:
Mailing address:
  • Phone: 415-221-3047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number0006341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: