Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 266797 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 266797 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | 266797 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3127 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 266797 | CA |
NPI | 1144269804 |
---|---|
Provider Name | Ms. Vicki Bernin Smith |
First Address | San Francisco, CA 94103-3732 |
Second Address | San Francisco, CA 94102-2735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 23/01/2014 |