Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | R229753 | CA |
NPI | 1124199963 |
---|---|
Provider Name | Ms. Catherine Marie Smith |
First Address | Santa Ana, CA 92706-2316 |
Second Address | Santa Ana, CA 92706-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 14/01/2015 |