MEDICARE: MS. SHEILA R SMITH MFT

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	106H00000X	Marriage & Family Therapist	MFC33287	CA

General Provider Information

NPI Number	:	1336230218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHEILA R SMITH MFT

Provider Business Mailing Address
First Line	:	17595 VIERRA CANYON RD # 194
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93907-3312
Country	:	US
Telephone Number	:	831-663-1339
Fax Number	:	831-663-1339

Provider Business Practice Location Address
First Line	:	30 E SAN JOAQUIN ST
Second Line	:	STE. 207
City	:	SALINAS
State	:	CA
Zip	:	93901-2945
Country	:	US
Telephone Number	:	831-663-1339
Fax Number	:	831-663-1339

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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