NPI Code Details Logo

NPI 1154527752

NPI 1154527752 : ANNE M SMURA : FOUNTAIN VALLEY, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1154527752
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ANNE M SMURA
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/21/2007
-----------------------------------------------------
    Last Update Date     |    07/08/2007
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    18643 BROOKHURST ST 
-----------------------------------------------------
    City                 |    FOUNTAIN VALLEY
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92708-6709
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    714-962-3867
-----------------------------------------------------
    Fax                  |    714-962-3477
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    24 HAMMOND STE C 
-----------------------------------------------------
    City                 |    IRVINE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92618-1680
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    949-770-6022
-----------------------------------------------------
    Fax                  |    949-770-7084
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    4486
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.