Healthcare Provider Details

I. General information

NPI: 1689129421
Provider Name (Legal Business Name): KERSTI SMITH CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 MADOC WAY
SAN JOSE CA
95130-2043
US

IV. Provider business mailing address

4414 MADOC WAY
SAN JOSE CA
95130-2043
US

V. Phone/Fax

Practice location:
  • Phone: 408-500-8844
  • Fax:
Mailing address:
  • Phone: 408-500-8844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: