Individual
AMY ELIZABETH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
783 AUGUSTA DR, MORAGA, CA 94556-1007
(510) 432-4268
Mailing address
783 AUGUSTA DR, MORAGA, CA 94556-1007
(510) 432-4268
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN294184
CA
Other
Enumeration date
10/03/2020
Last updated
10/03/2020
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