Provider Demographics
NPI:1417085101
Name:SMITH, VELMA MARIE (COUNSLOR)
Entity Type:Individual
Prefix:MISS
First Name:VELMA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:COUNSLOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4485 APPIAN WAY APT B
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2259
Mailing Address - Country:US
Mailing Address - Phone:510-223-5533
Mailing Address - Fax:
Practice Address - Street 1:820 VALENCIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1737
Practice Address - Country:US
Practice Address - Phone:415-920-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIN PROCESS101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)