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NPI Code Detail

MEDICARE: MISS BETTY SMITH

MEDICARE: MISS BETTY 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 : 1932231636
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS BETTY SMITH
Provider Business Mailing Address
First Line : 5300 COLE ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-5563
Country : US
Telephone Number : 510-261-4045
Fax Number :
Provider Business Practice Location Address
First Line : 1460 PINE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-4720
Country : US
Telephone Number : 415-202-0850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 11/16/2007

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Directions to “ MISS BETTY SMITH ” Practice Location

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