Provider Demographics
NPI:1669761003
Name:FISHMAN-SMITH, AMY JOY (RN, NP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JOY
Last Name:FISHMAN-SMITH
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JOY
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, NP
Mailing Address - Street 1:3419 E CHAPMAN AVE # 404
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3812
Mailing Address - Country:US
Mailing Address - Phone:714-782-0042
Mailing Address - Fax:650-241-1129
Practice Address - Street 1:1440 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2221
Practice Address - Country:US
Practice Address - Phone:714-782-0042
Practice Address - Fax:650-241-1129
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA393692163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory