Provider Demographics
NPI:1194843607
Name:SMITH, SUSAN J (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2415 UNIVERSITY AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1148
Mailing Address - Country:US
Mailing Address - Phone:650-363-4030
Mailing Address - Fax:650-328-6834
Practice Address - Street 1:2415 UNIVERSITY AVE STE 301
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1148
Practice Address - Country:US
Practice Address - Phone:650-363-4030
Practice Address - Fax:650-328-6834
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2020-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG736212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry