Individual
DEBORAH V. SMALLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
5609 INDIAN AVE, SAN JOSE, CA 95123-3238
(408) 224-4383
Mailing address
5609 INDIAN AVE, SAN JOSE, CA 95123-3238
(408) 224-4383
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12127
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA12127
PHYSICIAN ASST. LICENSE
CA
Enumeration date
03/19/2007
Last updated
06/29/2009
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