Provider Demographics
NPI:1093568594
Name:SMITH, SARAH MAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MAE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E KATELLA AVE APT 3060
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6658
Mailing Address - Country:US
Mailing Address - Phone:518-496-5895
Mailing Address - Fax:
Practice Address - Street 1:1801 E KATELLA AVE APT 3060
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6658
Practice Address - Country:US
Practice Address - Phone:518-496-5895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program