Katherine Elizabeth Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110013 Issued in CA

Practice address

2909 Omega Way
Modesto, CA 95355-7868

Phone

(209) 800-7922

NPI assigned

Apr 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1922628643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 DEER RD.",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "95490",
            "telephone_number": "909-921-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 OMEGA WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953557868",
            "telephone_number": "209-800-7922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 E Tulare Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932923629",
            "country_code": "US",
            "telephone_number": "559-368-6206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3500 W Mineral King Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932915635",
            "country_code": "US",
            "telephone_number": "559-713-5034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "776 S State St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954825858",
            "country_code": "US",
            "telephone_number": "707-463-4917 x125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW90626",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jakayla Smith
• Jaylah Monae Smith
• Jazzmin Smith
• Jody Lynn Smith
• Kalysa Smith
• Kimberly Anne Smith, PPS
• Lauren Smith
• Maelena Rico Smith
• Rhonda Michelle Smith, PHYSICIAN ASSISTANT
• Samantha Smith

• Clinical Social Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.