MEDICARE: MATTHEW KIERAN MADDEN-SMITH CERT # 38965

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
1	225700000X	Massage Therapist	38965	CA

General Provider Information

NPI Number	:	1154273985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW KIERAN MADDEN-SMITH CERT # 38965

Provider Business Mailing Address
First Line	:	1611 SAN PABLO AVE APT 4A
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-1376
Country	:	US
Telephone Number	:	510-307-6787
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 SAN PABLO AVE APT 4A
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-1376
Country	:	US
Telephone Number	:	510-307-6787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “ MATTHEW KIERAN MADDEN-SMITH CERT # 38965” Practice Location

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