Provider Demographics
NPI:1194873570
Name:SMITH, MARITA CATHARINE (PHD, MFT)
Entity type:Individual
Prefix:DR
First Name:MARITA
Middle Name:CATHARINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MIDDLEFIELD RD
Mailing Address - Street 2:STE. 100D
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4002
Mailing Address - Country:US
Mailing Address - Phone:650-306-0391
Mailing Address - Fax:
Practice Address - Street 1:200 MIDDLEFIELD RD
Practice Address - Street 2:STE. 100D
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4002
Practice Address - Country:US
Practice Address - Phone:650-306-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31524106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist