Provider Demographics
NPI:1689129421
Name:SMITH, KERSTI (CD(DONA))
Entity Type:Individual
Prefix:
First Name:KERSTI
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 MADOC WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-2043
Mailing Address - Country:US
Mailing Address - Phone:408-500-8844
Mailing Address - Fax:
Practice Address - Street 1:4414 MADOC WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95130-2043
Practice Address - Country:US
Practice Address - Phone:408-500-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula