Provider Demographics
NPI:1881043990
Name:SMITH, BARBARA (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MACARTHUR BLVD STE 14B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5260
Mailing Address - Country:US
Mailing Address - Phone:510-563-4300
Mailing Address - Fax:510-563-4320
Practice Address - Street 1:10700 MACARTHUR BLVD STE 14B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5260
Practice Address - Country:US
Practice Address - Phone:510-563-4300
Practice Address - Fax:510-563-4320
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513227163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health