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General NPI Number Information
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NPI Number | 1629080999
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Entity Type | Individual
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Provider Name | KATHLEEN MOREAU SMITH F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 1200 W GONZALES RD STE 300
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City | OXNARD
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State | CA
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Zip | 93036-3072
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Country | US
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Telephone | 805-983-0691
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Fax | 805-983-2026
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Provider Business Mailing Address
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Address Line | PO BOX 660879
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City | ARCADIA
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State | CA
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Zip | 91066-0879
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Country | US
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Telephone | 626-447-0296
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Fax | 626-447-6057
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP11751
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License Number State | CA
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