Doctor Name: | DR. CANDIA KATHRYN SMITH |
NPI Number: | 1073645297 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DMH |
License Number: | PSY12502 |
Business Practice Address: | 61 Moraga Way Suite 6 Orinda, CA - 945633097 |
Business Phone Number: | 9252547823 |
Business Fax Number: | |
Mailing Address: | 61 Moraga Way, Suite 6 ORINDA |
State: | CA |
Postal Code: | 945633097 |
Phone Number: | 9252547823 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0400X |
License Number: | PSY12502 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |