Provider Demographics
NPI:1164237558
Name:SMITH, JOSEPHINE E (ANMT)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:ANMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 LEAVENWORTH ST # 504
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2612
Mailing Address - Country:US
Mailing Address - Phone:415-933-5232
Mailing Address - Fax:
Practice Address - Street 1:317 LEAVENWORTH ST # 504
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2612
Practice Address - Country:US
Practice Address - Phone:415-933-5232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist