Individual provider Active NPI

Catherine Esther Smally, DNP, FNP-BC

  • Family Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1205469525
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010882 Issued in CA
Practice address
2000 Mowry Ave
Fremont, CA 94538-1716
Phone
(510) 797-1111
NPI assigned
Feb 14, 2020
Last updated
Mar 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010882 CA Primary

Addresses

Primary practice location

2000 Mowry Ave
Fremont, CA 94538-1716

Mailing address

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 517-5117

Other practice location 1

1601 Bayo Vista Ave
San Pablo, CA 94806-4110
Phone (510) 517-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230322002007 CA Practitioner - Nurse Practitioner 0042684656 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010882CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation CurrentSince Feb 6, 2023 Accepting new patients
Washington Township Medical Foundation CurrentSince Feb 6, 2023 Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1205469525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-517-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-797-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Bayo Vista Ave",
            "address_purpose": "LOCATION",
            "city": "San Pablo",
            "state": "CA",
            "postal_code": "948064110",
            "country_code": "US",
            "telephone_number": "510-517-5117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALLY",
        "first_name": "CATHERINE",
        "middle_name": "ESTHER",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.