Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY15654 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY15654 | CA |
NPI | 1013068659 |
---|---|
Provider Name | Dr. Dawn Marie Smith |
First Address | San Francisco, CA 94115-3035 |
Second Address | San Francisco, CA 94115-3035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/07/2007 |