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NPI Code Detail

MEDICARE: KATRINA SMITH

MEDICARE: KATRINA SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant

General Provider Information

NPI Number : 1083175129
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA SMITH
Provider Business Mailing Address
First Line : 360 MONTE VISTA AVE APT 206
Second Line :
City : OAKLAND
State : CA
Zip : 94611-4556
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2707 PINE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2522
Country : US
Telephone Number : 415-563-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2019
Last Update Date : 03/29/2019

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Directions to “ KATRINA SMITH ” Practice Location

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