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General NPI Number Information
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NPI Number | 1689337016
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Entity Type | Individual
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Provider Name | VICTORIA SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 2615 PACIFIC COAST HWY STE 324
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-2227
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Country | US
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Telephone | 424-253-5781
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Fax |
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Provider Business Mailing Address
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Address Line | 413 RICHMOND STREET 1/2
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City | EL SEGUNDO
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State | CA
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Zip | 90245
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Country | US
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Telephone | 310-848-5922
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 104872
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License Number State | CA
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