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General NPI Number Information
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NPI Number | 1225110380
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Entity Type | Individual
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Provider Name | DIANE M. SMITH MFT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16960 BASTANCHURY RD SUITE J
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City | YORBA LINDA
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State | CA
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Zip | 92886-1711
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Country | US
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Telephone | 714-449-2444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1706
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City | ORANGE
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State | CA
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Zip | 92856-0706
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Country | US
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Telephone | 714-997-5384
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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 | MFC 33630
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License Number State | CA
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