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General NPI Number Information
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NPI Number | 1790100147
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Entity Type | Individual
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Provider Name | JUDITH SMITH M.A., LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 02/21/2014
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Provider Practice Location Address
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Address Line | 916 SILVER SPUR RD SUITE 305A
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-3810
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Country | US
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Telephone | 310-722-8489
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Fax |
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Provider Business Mailing Address
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Address Line | 205 S HELBERTA AVE # A
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3451
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Country | US
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Telephone | 310-722-8489
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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 | 50642
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License Number State | CA
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