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General NPI Number Information
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NPI Number | 1225396450
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Entity Type | Individual
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Provider Name | CASSANDRA SMITH LVN
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Gender | Female
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 4725 1ST ST
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City | PLEASANTON
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State | CA
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Zip | 94566-7366
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Country | US
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Telephone | 925-417-5726
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Fax |
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Provider Business Mailing Address
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Address Line | 27212 CALAROGA AVE HAYWARD
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City | HAYWARD
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State | CA
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Zip | 94545-4339
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Country | US
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Telephone | 510-785-5000
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 79143
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License Number State | CA
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