Provider Demographics
NPI:1083795603
Name:SIMMONS, ANDREA FRANCESCA (LPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:FRANCESCA
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LPT
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Other - Credentials:
Mailing Address - Street 1:3623 S LELAND ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-6425
Mailing Address - Country:US
Mailing Address - Phone:310-222-3140
Mailing Address - Fax:310-533-8019
Practice Address - Street 1:24330 NARBONNE AVE
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-1131
Practice Address - Country:US
Practice Address - Phone:213-305-3192
Practice Address - Fax:310-257-0213
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2021-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT18067167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician