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General NPI Number Information
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NPI Number | 1902205156
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Entity Type | Individual
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Provider Name | KATHRYN CASSIDY SMITH M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 08/13/2014
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Provider Practice Location Address
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Address Line | 480 MANOR PLZ
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City | PACIFICA
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State | CA
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Zip | 94044-1839
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Country | US
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Telephone | 650-516-0329
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Fax |
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Provider Business Mailing Address
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Address Line | 18 MONTELL ST APT. 5
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City | OAKLAND
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State | CA
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Zip | 94611-4932
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Country | US
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Telephone | 719-761-8720
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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