Provider Demographics
NPI:1447751904
Name:SMITHEY, DAWN PATRICE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:PATRICE
Last Name:SMITHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 W SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6537
Mailing Address - Country:US
Mailing Address - Phone:310-733-0407
Mailing Address - Fax:
Practice Address - Street 1:5731 W SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6537
Practice Address - Country:US
Practice Address - Phone:310-733-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist