Individual
MR. FRED SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1308 LANI KAI DR, #C1, CONCORD, CA 94520-2898
(925) 339-6986
Mailing address
1308 LANI KAI DR, #C1, CONCORD, CA 94520-2898
(925) 339-6986
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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