Provider Demographics
NPI:1467741124
Name:SMITH, HUGHZETTA
Entity Type:Individual
Prefix:
First Name:HUGHZETTA
Middle Name:
Last Name:SMITH
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 1:637 E ALBERTONI ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1539
Mailing Address - Country:US
Mailing Address - Phone:310-532-0063
Mailing Address - Fax:310-626-9754
Practice Address - Street 1:637 E ALBERTONI ST
Practice Address - Street 2:SUITE 109
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1539
Practice Address - Country:US
Practice Address - Phone:310-532-0063
Practice Address - Fax:310-626-9754
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)