MEDICARE: DENISE SMERNES M.F.T.

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	101YM0800X	Mental Health Counselor	MFT32467	CA

General Provider Information

NPI Number	:	1346261823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE SMERNES M.F.T.

Provider Business Mailing Address
First Line	:	2220 MOUNTAIN BLVD STE 240
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-2905
Country	:	US
Telephone Number	:	510-336-0637
Fax Number	:	510-482-3405

Provider Business Practice Location Address
First Line	:	2220 MOUNTAIN BLVD STE 240
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-2905
Country	:	US
Telephone Number	:	510-336-0637
Fax Number	:	510-482-3405

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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