Provider Demographics
NPI:1235291337
Name:SIMNEGAR, RAY (PHD)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:SIMNEGAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2401
Mailing Address - Country:US
Mailing Address - Phone:415-861-5096
Mailing Address - Fax:415-861-5097
Practice Address - Street 1:314 HARRIET ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4716
Practice Address - Country:US
Practice Address - Phone:415-861-5096
Practice Address - Fax:415-861-5097
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6507103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist