| Doctor Name: | KRISTINE THERESA SMIRCICH |
| NPI Number: | 1518377084 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SP |
| License Number: | 9686 |
| Business Practice Address: | 1101 B Gale Wilson Blvd Suite 101a Fairfield, CA - 945333700 |
| Business Phone Number: | 7076464150 |
| Business Fax Number: | 7076464153 |
| Mailing Address: | 1200 B Gale Wilson Blvd, Attn Rehab Dept FAIRFIELD |
| State: | CA |
| Postal Code: | 945333552 |
| Phone Number: | 7076464150 |
| Fax Number: | |
| NPI Enumeration Date: | 05/05/2014 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 9686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |