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General NPI Number Information
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NPI Number | 1457514010
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Entity Type | Individual
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Provider Name | DIANA ELIZABETH SMITH MFT
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Gender | Female
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 2100 MONUMENT BLVD SUITE 16
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City | PLEASANT HILL
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State | CA
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Zip | 94523
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Country | US
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Telephone | 925-812-1240
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Fax | 925-969-3121
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Provider Business Mailing Address
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Address Line | 110 TERRA LANE
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City | PACHECO
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State | CA
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Zip | 94553-5579
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Country | US
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Telephone | 925-685-6283
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Fax | 925-969-3121
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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 | MFC42777
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License Number State | CA
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