Provider Demographics
NPI:1295052397
Name:SMIDKOVA, BOHDANA
Entity type:Individual
Prefix:
First Name:BOHDANA
Middle Name:
Last Name:SMIDKOVA
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 1:777 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3614
Mailing Address - Country:US
Mailing Address - Phone:415-259-1553
Mailing Address - Fax:
Practice Address - Street 1:777 11TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3614
Practice Address - Country:US
Practice Address - Phone:415-259-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor