MEDICARE: DAWN PATRICE SMITHEY

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	98133	CA

General Provider Information

NPI Number	:	1447751904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN PATRICE SMITHEY

Provider Business Mailing Address
First Line	:	5731 W SLAUSON AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6537
Country	:	US
Telephone Number	:	310-733-0407
Fax Number	:

Provider Business Practice Location Address
First Line	:	5731 W SLAUSON AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6537
Country	:	US
Telephone Number	:	310-733-0407
Fax Number	:

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

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/21/2018

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Directions to “ DAWN PATRICE SMITHEY ” Practice Location

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