Provider Demographics
NPI:1093862781
Name:SMITH, ERIC V (MEDICAL CASE WORKER)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:V
Last Name:SMITH
Suffix:
Gender:M
Credentials:MEDICAL CASE WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17707 STUDEBAKER RD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2640
Mailing Address - Country:US
Mailing Address - Phone:562-467-0209
Mailing Address - Fax:562-924-5706
Practice Address - Street 1:17707 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2640
Practice Address - Country:US
Practice Address - Phone:562-924-0209
Practice Address - Fax:562-924-5706
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor