MEDICARE: DR. CATHERINE B SMITH PSYD

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	LMFT124879	CA
2	103TC0700X	Clinical Psychologist	PSY34891	CA

General Provider Information

NPI Number	:	1417487125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE B SMITH PSYD

Provider Business Mailing Address
First Line	:	171 PIER AVE # 111
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-5311
Country	:	US
Telephone Number	:	310-564-6164
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 PIER AVE # 111
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-5311
Country	:	US
Telephone Number	:	310-564-6164
Fax Number	:

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	02/19/2025

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