Provider Demographics
NPI:1003165580
Name:SIMSON, WYNN AND WILLIAMS
Entity Type:Organization
Organization Name:SIMSON, WYNN AND WILLIAMS
Other - Org Name:WELCOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DRAD, MCA, MRAS
Authorized Official - Phone:916-476-6301
Mailing Address - Street 1:7844 MADISON AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3519
Mailing Address - Country:US
Mailing Address - Phone:916-476-6301
Mailing Address - Fax:
Practice Address - Street 1:7844 MADISON AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3519
Practice Address - Country:US
Practice Address - Phone:916-476-6301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health