Individual provider · Type 1 NPI

Shannon Lara Smith

Student in an Organized Health Care Education/Training Program · Berkeley, CA

NPI number 1336329564 Active

Practice location

3200 Adeline Street
Berkeley, CA 94703-3501

Call (415) 859-6264 Map

Mailing address

3200 Adeline St
Berkeley, CA 94703-2407

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1336329564

Shannon Lara Smith's National Provider Identifier is 1336329564, issued on Nov 5, 2007. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Berkeley, CA. The record was last updated on Jul 31, 2008.