1346513363 NPI number — MR. MICHEAL FRANCES SMITH CA LMFT (M.A.)

Table of content: MR. MICHEAL FRANCES SMITH CA LMFT (M.A.) (NPI 1346513363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346513363 NPI number — MR. MICHEAL FRANCES SMITH CA LMFT (M.A.)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
MICHEAL
Provider Middle Name:
FRANCES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CA LMFT (M.A.)
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346513363
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 MERCER AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OJAI
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-888-9254
Provider Business Mailing Address Fax Number:
805-669-3525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2021 SPERRY AVENUE
Provider Second Line Business Practice Location Address:
SUITE 22
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-888-9254
Provider Business Practice Location Address Fax Number:
805-669-3525
Provider Enumeration Date:
02/22/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  IMF 58558 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT51393 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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