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General NPI Number Information
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NPI Number | 1174070924
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Entity Type | Individual
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Provider Name | MAUREEN Y SMITH LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 11100 SAN PABLO AVE STE 205
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City | EL CERRITO
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State | CA
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Zip | 94530-2100
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Country | US
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Telephone | 415-328-3202
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | SAN GERONIMO
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State | CA
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Zip | 94963-0426
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Country | US
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Telephone | 415-488-4277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 111248
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License Number State | CA
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