Provider Demographics
NPI:1528182938
Name:SMIDDY HUSHER, CATHERINE ELIZABETH (OTRL)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:SMIDDY HUSHER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LAS PLUMAS AVE STE K
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1657
Mailing Address - Country:US
Mailing Address - Phone:408-272-6744
Mailing Address - Fax:408-259-0865
Practice Address - Street 1:1650 LAS PLUMAS AVE STE K
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1657
Practice Address - Country:US
Practice Address - Phone:408-272-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8249225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist