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NPI Code Detail

MEDICARE: PALO ALTO SMART THERAPY

MEDICARE: PALO ALTO SMART THERAPY
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
1106H00000XMarriage & Family TherapistMFT18361CA
2103T00000XPsychologistPSY23220CA

General Provider Information

NPI Number : 1144642570
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALO ALTO SMART THERAPY
Provider Business Mailing Address
First Line : 825 SAN ANTONIO RD STE 108
Second Line :
City : PALO ALTO
State : CA
Zip : 94303-4620
Country : US
Telephone Number : 650-248-0754
Fax Number :
Provider Business Practice Location Address
First Line : 825 SAN ANTONIO RD STE 108
Second Line :
City : PALO ALTO
State : CA
Zip : 94303-4620
Country : US
Telephone Number : 650-248-0754
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. KRISTA REGEDANZ
Credential : PH.D.
Telephone Number : 650-248-0754
Provider Enumeration Date : 01/21/2014
Last Update Date : 05/05/2014

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Directions to “PALO ALTO SMART THERAPY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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