1235389925 NPI number — DR. FERRI DEMETRICE SMITH AU.D.

Table of content: DR. FERRI DEMETRICE SMITH AU.D. (NPI 1235389925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235389925 NPI number — DR. FERRI DEMETRICE SMITH AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
FERRI
Provider Middle Name:
DEMETRICE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
IRIME
Provider Other First Name:
FERRI
Provider Other Middle Name:
DEMETRICE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
AU.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235389925
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VALLEY SPECIALTY CENTER ENT/AUDIOLOGY
Provider Second Line Business Mailing Address:
751 SOUTH BASCOM AVE, FL 4 AND SUITE 410
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-885-7992
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SANTA CLARA VALLEY MEDICAL CENTER, ENT/AUDIOLOGY DEPT
Provider Second Line Business Practice Location Address:
751 SOUTH BASCOM AVENUE, 4TH FLOOR, STE 410
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-885-7992
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  9989 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: 3401 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)