Provider Demographics
NPI:1114959780
Name:SIMMONS, STEVEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 WATT AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2622
Mailing Address - Country:US
Mailing Address - Phone:916-484-0321
Mailing Address - Fax:916-481-6830
Practice Address - Street 1:3800 WATT AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2622
Practice Address - Country:US
Practice Address - Phone:916-484-0321
Practice Address - Fax:916-481-6830
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0284290Medicare ID - Type Unspecified
CAU91940Medicare UPIN