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NPI Code Detail

MEDICARE: EILEEN SMITH

MEDICARE: EILEEN 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1225326390
Entity Type Code : Individual
Provider Name (Legal Business Name) : EILEEN SMITH
Provider Business Mailing Address
First Line : 2560 PULGAS AVE
Second Line :
City : EAST PALO ALTO
State : CA
Zip : 94303
Country : US
Telephone Number : 650-325-6466
Fax Number :
Provider Business Practice Location Address
First Line : 2560 PULGAS AVE
Second Line :
City : EAST PALO ALTO
State : CA
Zip : 94303-1323
Country : US
Telephone Number : 650-325-6466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2011
Last Update Date : 07/11/2011

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Directions to “ EILEEN SMITH ” Practice Location

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