Provider Demographics
NPI:1114039641
Name:SIMPSON, ROBERT DOUGLAS (MA MFT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DOUGLAS
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18671 ALLEGHENY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-2104
Mailing Address - Country:US
Mailing Address - Phone:714-997-9600
Mailing Address - Fax:714-997-9607
Practice Address - Street 1:18671 ALLEGHENY DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-2104
Practice Address - Country:US
Practice Address - Phone:714-997-9600
Practice Address - Fax:714-997-9607
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC8859106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist