Provider Demographics
NPI:1386511491
Name:SMITH, ANNA CAITLIN
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CAITLIN
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 1:5938 JAMIESON AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1018
Mailing Address - Country:US
Mailing Address - Phone:518-878-5857
Mailing Address - Fax:518-878-5857
Practice Address - Street 1:5938 JAMIESON AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1018
Practice Address - Country:US
Practice Address - Phone:518-878-5857
Practice Address - Fax:518-878-5857
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT153448103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist