Gary James Smith, CADC II, ICADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A021151115 Issued in CA

Practice address

416 2ND Ave
San Mateo, CA 94401-3205

Phone

(650) 579-7158

NPI assigned

Oct 18, 2019

Last updated

Oct 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1083257323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S EL CAMINO REAL STE 200",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032382",
            "telephone_number": "650-579-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 2ND AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013205",
            "telephone_number": "650-579-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "credential": "CADC II, ICADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A021151115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christina Mary Smith
• Nicole Sandra Smith
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• Vernell Angenette Smith, MD
• Wayne Smith Jr.
• Ameera Kimiko Snell, RN

• Addiction (Substance Use Disorder) Counselor in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.