Provider Demographics
NPI:1356512123
Name:JAMES SIMMONS, KIMBERLY V
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:V
Last Name:JAMES SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-3926
Mailing Address - Country:US
Mailing Address - Phone:415-864-3057
Mailing Address - Fax:415-864-3163
Practice Address - Street 1:1175 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3926
Practice Address - Country:US
Practice Address - Phone:415-864-3057
Practice Address - Fax:415-864-3163
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)